Fillable Printable Narrative Statements
Fillable Printable Narrative Statements
![Narrative Statements](/resources/formfile/images/gov1218/narrative-statements-page1.png)
Narrative Statements
![](/resources/formfile/htmls/gov1218/narrative-statements/bg1.png)
DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
INDIAN HEALTH SERVICE
PUBLIC LAW 94-437 – TITLE I SCHOLARSHIP PROGRAM
NARRATIVE STATEMENTS
FORM APPROVED:
OMB Approval No: 0917-0006
Exp. Date: 08/31/2013
See Estimated Average Burden Time
per Response on Reverse Side.
APPLICANT’S NAME SOCIAL SECURITY NUMBER
DEGREE TRACK IHS AREA OFFICE EMAIL ADDRESS
Explain why you are requesting this scholarship**
State your career goals**
Explain how these goals will help to meet the health needs of the Indian people**
** If more space is required, use addi tional sh eets of 8 1/2” x 1 1” paper. Wri te your n ame and social sec urity num ber on ea ch additi onal shee t of paper. Securely a ttach
additional sheets to this form.
IHS-856-4 EF