180 Medical Caregiver Scholarship ProgramEligibility In order to be eligible, applicants must be an unpaid caregiver to a family member or loved one who lives with a chronic disability or medical condition requiring consistent in-home care. Must be attending a two-year, four-year, or graduate school program full time in the fall. Medical school students are not eligible to apply. Must be a legal resident of the United States.

Deadline Application must be postmarked on or before June 1st.

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For application information, visit: www.180medical.com/caregiver-scholarship

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About 180 Medical180 Medical is one of the leading providers of catheters, ostomy products, and incontinence supplies in the United States. 180 Medical aims to offer high-quality products paired with unparalleled customer service.

About RonBefore serving as President of 180 Medical, Ron led a varied and rich career in the United States Air Force, where he learned and embraced the core values of “Integrity first, service before self, and excellence in all we do.” For years, Ron dedicated himself to these values during his time in service.

This ultimately led to a perfect fit at 180 Medical as Ron continued his career path as a civilian after retiring from the military. Ron served numerous roles in leadership and sales throughout the nearly 15 years of his career here before taking over as President of 180 Medical in 2015. During his time as President, Ron worked hard to uphold 180 Medical’s primary values, including compassion, service, and integrity, while also honoring our Founder Todd Brown’s legacy.

As a father, son, friend, and brother, Ron understands firsthand how important taking the role of a caregiver can be. In addition, he feels that the values that have guided much of his life and shaped his character are central components to caregiving.

Scholarship AwardsEligibility Requirements: In order to be eligible, applicants must be an unpaid caregiver to a family member or loved one who lives with a chronic disability or medical condition requiring consistent in-home care. Must be attending a two-year, four-year, or graduate school program full time in the fall. Medical school students are not eligible to apply. Must be a legal resident of the United States.

Application Deadline: The 180 Medical Scholarship Program accepts applications from January 1, 2020 – June 1, 2020. All materials must be postmarked by June 1, 2020. Application materials must be mailed in one packet. If possible, transcripts should not be sent separately. If you choose to email your application, please include all materials and send to CaregiverScholarship@180medical.com.

2020 180 Medical Ron Howell Caregiver College Scholarship

APPLICATION INFORMATION

Ron Howell, President of 180 Medical

Please fill out completely.

Are you a U.S. Citizen? o Yes o No

Fall ‘20 Status: o College Freshman o College Sophomore o College Junior o College Senior o Graduate School Est. Grad Date:

Full Legal Name First Middle Last Gender

Permanent Address

City State Zip Code

Date of Birth Telephone # Cell # Email Address

High School Name Address City, State, Zip Code

SAT or ACT Score High School Cumulative GPA

Current College (if applicable) Name Address City, State, Zip Code

College Cumulative GPA (if applicable) College Student ID

College you will attend Fall 2020 Name Address

City State Zip Code Major

How did you hear about this scholarship opportunity?

Please respond to the following questions.Attach your typed responses to this form.

1. List your extracurricular activities (sports, community, employment, etc.) from the last two years. Indicate the dates you participated in the activities.

2. List any significant awards or honors you have received during the last two years for academic or extracurricular achievements.

Essay or Video: (750 word or 5 minutes maximum) Tell your caregiving story. Include how being a caregiver has affected your life and explain your goals for the future.

Transcript: Please submit an official transcript including your most current semester with your application materials.

College Acceptance Letter: Submit a copy of an acceptance letter or current enrollment documentation.

o Internet Search o Scholarship Directory o Facebooko Friend o Other

FINAL DEADLINE: JUNE 1, 2020

By submitting this application, I believe all of the above information to be true and complete, and I hereby apply for the 180 Medical Scholarship. I certify that I am not currently receiving full funding for my education. I authorize 180 Medical to obtain and review my academic records. By submitting this application, I authorize 180 Medical to use my name, photo, and any part of essay or video.

Applicant Signature(Required)

2020 180 Medical Caregiver Scholarship Application

To be considered for a scholarship, you must include the following:

o Completed applicationo Typed questionso Typed essay or videoo Most recent official transcripto Document verifying acceptance by college or current enrollment

Send all materials to:180 MedicalAttn: Caregiver Scholarship Committee8516 NW ExpresswayOklahoma City, OK 73162

Or e-mail to CaregiverScholarship@180medical.com.

All materials must be postmarked before June 1, 2020.

Scholarship award winners will be announced on 180 Medical’s Facebook page by August 1, 2020.

Please do not check on the status of your application.

2020 180 Medical Caregiver Scholarship Program Checklist

Catheter, Ostomy, & Incontinence Supply SpecialistsPh: (877) 688-2729 | Fax: (888) 718-0633 | www.180medical.com

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