Fairbanks Memorial Hospital Student Services/Interior AHEC
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    FHP Student Services/Alaska AHEC Program Participant Form

    *In order for us to provide grant-funded programs, we are required to ask certain information from all participants. Your personal information will be handled with complete confidentiality and not shared outside of the AHEC organization or Foundation Health Partner: TVC/FMH/DC.

    Can you answer yes to either one of these statements?
    -I am the first generation in my family to attend college.
    -I attend(ed) a small rural high school.

    Can you answer yes to either one of these statements?
    -I had or currently receive a scholarship or loan for disadvantaged students.
    -While growing up, I or my family used federal or state assistance programs (such as: free or reduced school lunch, WIC, food stamps, medicade, subsidized housing, etc.


Submit
Interior Alaska Area Health Education Center (AHEC) - In Partnership With: Foundation Health Partners, Chief Andrew Isaac Health Center, and the Interior Public Health Partners.