Scholarship Application Form

    High School SeniorCollege

    Angie Tillman Medical Scholarship Form


    The Angie Tillman Nursing Scholarship is designed to help students who are pursuing a BSN degree. Applicants must meet all of the following criteria:

    1. Be a graduating high school senior.
    2. Be a (please check one):

    3. Have a minimum of a 3.5 cumulative grade point average.
    4. Intend to enroll as a full-time student at an accredited college or university in Tennessee to pursue a BSN degree.


    List school-related activities and/or organizations in which you have participated. Include sports, student government, etc. within the last four years. Attach an additional sheet if necessary

    Name of Organization/Activity

    Year(s) Participated

    List awards, honors or offices held within the last four years. Attach an additional sheet if necessary.



    List community activities/organizations, volunteer projects or programs in which you have participated within the last four years. Include work history. Attach an additional sheet if necessary.

    Community Activities/Organizations

    Participation Level/Position/Job Title

    Years Participated

    To which college/university have you been accepted? (Attach letter of acceptance at bottom of form.)

    Include with this application a written essay of 300 words or less responding to the following:

    1. When did you first realize you wanted to be a nurse, and what led you to this decision?
    2. What qualities would you bring to the field of nursing?


      If your guidance counselor would like to send your transcript directly to us, please have them email it to: Angie Birkemeyer at Otherwise, attach your transcript below.

    1. Official high school and college (if applicable) transcripts and ACT and/or SAT scores.

    2. Copy of college/university acceptance letter.
    3. Typed, double-spaced applicant essay explaining the qualities he or she would bring to the field of nursing. Limit is 300 words.
    4. Minimum of three letters of recommendation—one from a school counselor, one from a faculty member and/or employer, and one personal recommendation from someone other than a family member.

    Criteria for Selection
    Only complete applications (including entry materials) submitted by the deadline of April 16, 2021will be considered.

    Scholarships are awarded on the basis of academic merit, career interest and interview results. Recipients will be selected and notified by phone with written confirmation to follow no later than May 17, 2021.

    For more information, call WMC’s Volunteer Program senior coordinator at 615.435.5429.

    Consent for Release of Information

    I hereby consent to the release of any information in connection with the foregoing application that in the sole judgment of Williamson Medical Center Volunteer Auxiliary Scholarship Committee may be of assistance in evaluating my scholarship application. I hereby waive any confidentiality with respect to such information insofar as the Williamson Medical Center Volunteer Auxiliary Scholarship Committee is concerned, since it is my understanding that the information will be used solely for the evaluation of my application for a scholarship and for no other purpose.

    Signature of applicant

    Parent/Guardian Statement

    I have read this scholarship application and confirm the accuracy of its contents

    Signature of parent(s)
    or guardian(s)