The IAAPOC Scholarship is given annually to a deserving student in Prosthetics and/or Orthotics. The Scholarship honors Mr. Sam D. Benson, C.O. who was certified by the American Board for Certification in 1981. Mr. Benson is a founding member of the Coalition and he became the first President of the IAAPOC . The IAAPOC was established in 1990 to promote the P & O profession in the African American Community.  The Scholarship is funded by members of IAAPOC and their many supporters in the P&O Community. We appreciate this opportunity to assist you in your request.

Qualifications:

Applicant must be of African Descent

Applicant must be enrolled in an accredited Prosthetic & Orthotic program or accepted into an accredited program.

Name: ________________________________

Address: ________________________________

City: ___________________ State: _______________ Zip: ___________

Phone: _______________ Cell: _______________E-Mail: _________________

High School Education:

School: _____________________________

City: ________________________State:_______________________

GPA: ________________________

Undergraduate Studies:

College or University ______________________________________

Address: ____________________________________

City: _________________________ State: _________ Zip: _________

Major: ________________________ Minor: ____________________

Degree: _______________________________ GPA: ___________________

Contact Person: __________________________________________

Post Graduate Studies:

College or University _________________________________

Address: _______________________________

City: ______________________ State: _______ Zip: ____________

Prosthetics: _____ Orthotics: ______ Contact Person: ____________________

GPA: ____________________

Please list two references; one must be a certified prosthetist or orthotist.

Name: __________________________

Address: __________________________ City: ______________ State: _____

Phone: _____________________

Name: ___________________________

Address: ___________________________ City: ______________ State: _____

Phone: ______________________

Please summit a 200 word essay stating why you chose to enter the field of Prosthetics & Orthotics and a recent photo of yourself. Your application and essay will be reviewed by IAAPOC Scholarship Committee.

I _____________________________ certify that the above information including the essay is true. I also authorize IAAPOC, IAAPOC Scholarship Committee, and agents of IAAPOC to contact my references, schools, and my employers to verify the information given.

Signature: ____________________________ Date: ___________

Mail to: Bernadette B. Douroux, CPO
             Douroux Prosthetic-Orthotic Services
             P O Box 661
             Destrehan, LA 70047