Self Service Portal

SHPEP Alumni Scholarships

Email*
Repeat Email*

Password*
Repeat Password*
Prefix*
First Name*
Middle Name/Intitial
Last Name*
Suffix
Degrees

add degree(s) or reset

D.D.S.
D.M.D.
B.D.S.
D.H.Sc.
D.M.Sc.
Dr.P.H.
LDH
RDH
Ph.D.
M.P.H.
M.S.
Ed.D.
A.A.

M.Sc.
GS-ED
J.D.
LHD
M.A.
M.B.A.
M.D.
M.Ed.
M.H.P.

M.H.S.
M.H.S.A.
M.M.Sc.
M.S.D.H.
A.A.S.
A.S.
B.A.
B.A.S.-D.H.
B.L.S./B.S.
B.S.

B.S.A.H.
B.B.A.
B.S.-D.H.
B.S.-D.H.E.
B.S.-G.S.
B.S.H.A.
B.S.H.E.
D.O.
B.S-P.H.

D.C.
D.V.M.
M.P.A.
Pharm.D.

Address Type*
Street Line 1*
Street Line 2
City*
State/Province*
Country*
Postal Code*
Phone

Academic Information

Which SHPEP alumni scholarship are you applying for?*
- Rubens J. Pamies, MD, Opportunity Fund Scholarship

Current Status*

School/University*

If a recent graduate:

Graduation Year*

If a current student:

Anticipated Graduation Year*

Separate multiple Majors/Minors with a comma. If none, then write "None" or "Does Not Apply"

Major(s)*

Minor(s)

Health Profession Career Pathway*

Personal Information

Current gender identity*
- Woman
- Man
- Transgender man
- Transgender woman
- Genderqueer/Gender non-conforming
- Other:
- Prefer not to state

Optional - Please indicate your race/ethnicity (as many as may apply).

Race/Ethnicity
- American Indian/Alaska Native
- Arab
- Asian
- Black/African American
- Hispanic/Latinx
- Native Hawaiian/Other Pacific Islander
- Nonresident Alien
- White/Caucasian
- Métis (Canada only)
- Multiple Visible Minority (Canada only)
- Non-Aboriginal/Non-Indigenous (Canada only)
- First Nation (Canada only)
- Inuit (Canada only)
- Not a Visible Minority (Canada only)
- Other:
- Prefer not to state

Optional - If you are of Latinx/Hispanic cultural origin, make a selection below (as many as may apply)

Latinx/Hispanic Origin
- Cuban
- Mexican, Mexican American, Chicano/Chicana
- Puerto Rican
- South or Central American
- Other Spanish culture or origin:
- Does not apply
- Prefer not to state