Scholarship Award: Outstanding EMS Contribution by High School Senior

Outstanding Contribution to EMS by a HS Senior

Scholarship Application Form

AWARD CRITERIA: This competitive $1,000 scholarship will be awarded to a high school senior who has been affiliated with an EMS agency within the CSEMS Region for at least six months, and who is currently enrolled or will be enrolled in an institution of higher learning or an accredited ALS training program in the coming year.

Applicants Information

Do your best to provide as much information as possible to assure the individual qualifies for the nomination.

Nominee's Qualifications & Award Justification

Describe the nominee’s qualities and contributions (local, regional and state) to EMS in Virginia. Why is the nominee exceptionally qualified? Why should the nominee be selected for an award?

Application Certification


Checklist of items that must be submitted to via USPS to Central Shenandoah EMS Council:

-Proof of the applicant’s affiliation with a Virginia licensed EMS agency. (Statement on Agency letterhead. Can be included as part of one of the letters of recommendation)
-Evidence of high school senior status, with documentation of the applicant’s cumulative grade point average. (No minimum GPA is required, but will be considered in evaluations)
-At least two letters of recommendation on appropriate letterhead attesting that the nominee’s academic and/or EMS performance is consistent with the highest standards. One of the two letters of recommendation must be from an agency officer attesting to the applicant’s level of activity within the agency.
-Digital Photograph of the applicant may be emailed to Ed Moreland at

*Photo Required: A photo of the nominee must be included. Try to send a color photo (with good lighting) with just the nominee in it.

Important: Please send high resolution digital photos with 300 DPI or greater. Please do not send photos of I.D. badges. These are not high enough quality and do not show clearly when presented on a PowerPoint at the Governor’s EMS Awards ceremony. This will help assure the best image when used in publicity and printing.