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Orange County Pediatric Specialties Physician Loan Repayment Program Application Instructions

Orange County Pediatric Specialties Physician Loan Repayment Program Application Instructions. Health Professions Education Foundation.

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Orange County Pediatric Specialties Physician Loan Repayment Program Application Instructions

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  1. Orange County Pediatric Specialties Physician Loan Repayment Program Application Instructions

  2. Health Professions Education Foundation The Foundation is the state’s only 501 (c) (3) non-profit, public benefit corporation statutorily created to provide financial assistance to health professional students and graduates throughout California who agree to practice in medically underserved areas.

  3. Orange County Pediatric Specialties Physician Loan Repayment Program Award Cycle deadlines occur annually on March 24. Applicants may receive up to $125,000 in exchange for a three year commitment to serve underserved children in Orange County.

  4. ApplicationOrange County Pediatric Specialties Physicians Loan Repayment ProgramDownload the application here:http://www.oshpd.ca.gov/HPEF/OCPSPLRP.html

  5. ApplicationInstructions READ ALL OF THE INSTRUCTIONS Call 800-773-1669 if you have questions.

  6. ApplicationInstructions, page 2 Eligible Practice Settings: Located in Orange County, CA NOTE: Should you have any questions about potential practice settings in Orange County, please contact: Dian Milton, Executive Director California Chapter 4 American Academy of Pediatrics 17320 Red Hill, Suite 120 Irvine, CA 92614 (949) 752-2787 (M-F, 8am-5pm) dmilton@aapca4.org

  7. ApplicationPage 1 Basic Information Part A Complete ALL spaces. Provide ALL requested information Use Drop Down Menus when available Use dd/mm/yyyyformat for dates Check to make sure your information is accurate! Service Obligation: “Contractual obligation agreed to by the recipient of a loan repayment where the recipient agrees to practice for a specific time in or through a designated facility.” If YES, you are INELIGIBLE for this program. Do NOT submit an application.

  8. ApplicationPage 2 Qualifications Part B Complete ALL spaces Provide ALL requested information Use Drop Down Menus when available Use dd/mm/yyyyformat for dates

  9. ApplicationPage 3 Personal Statement Part C Attach your personal statement to the application. Your statement must be typed and double spaced and no more than two (2) pages. Restate and number each question along with your answer. Additional pages will not be read or reviewed. 1. Describe your professional experience (paid or volunteer) in working with medically underserved populations. 2. Describe/explain your interest in working in a medically underserved community. 3. Explain your interest in serving underserved children through age five in Orange County. 4. Please include any other information you feel is relevant.

  10. ApplicationPage 4 References and Application Certification Part E Complete ALL spaces. Provide ALL requested information Check to make sure your information is accurate SIGN and DATE your application! If received unsigned and dated, your application will be incomplete and ineligible.

  11. ApplicationPage 5 Certification of Practice Setting Part G Print out this page Have your Administrative Office or Direct Supervisor complete and Sign/Date the document. Please refer to the Instructions for further information.

  12. ApplicationPage 6 Educational Debt Report Part H Complete ALL spaces. Provide ALL requested information Check to make sure your information is accurate! Verify Lender’s Payment Address

  13. ApplicationPage 7 Application & Document Checklist Part I Print out this page. Manually check each box when you verify that the information is complete and included in your package. Send your completed documents postmarked by March 24, 2011 to: Health Professions Education Foundation Attn: OCPED 400 R Street, Suite 460 Sacramento, CA 95811

  14. Dennis Stettner Director of Programs Administration (916)326-3642 Lisa Fernandes Program Officer (916) 326-3654 Health Professions Education Foundation 400 R Street, Suite 460 Sacramento, CA 95811 www.healthprofessions.ca.gov Download the application here:http://www.oshpd.ca.gov/HPEF/OCPSPLRP.html

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