This application form was revised 3/11/13.
Please read before completing the application form below. Every question must be answered. You cannot save information and return to the form later. It must all be completed at one time.
Please email the items listed below to ISP@NationwideChildrens.org.
1. Curriculum Vitae – Include education and professional experience
2. One color picture of yourself no larger than 2 ½ x 3 ½ inches
3. Proof of English Competency
4. Copy of medical degree or license with certified English translation.
5. Immunization record and either a negative tuberculin skin test OR a chest x-ray report taken within 6 months.
6. Previous International Educational Experiences
Stecker Scholar, Independently Funded, and Rotary Program Applicants:
7. Letters of recommendation– final determination will not be made until received
8. Signed Memorandum of Agreement (Stecker Scholar and Rotary Applicants)
9. Signed Memorandum of Agreement (Independent Applicants)
10. Health and Conduct Agreement
Please Note: The Stecker Scholarship deadline has been changed to March 15th effective immediately.
You may complete the application online or download the application and email it or send it to:
Nationwide Children's Hospital
International Scholars Program
700 Children's Drive
Columbus, OH 43205
Please email us at ISP@NationwideChildrens.org if you have questions.