Sam D. Benson Scholarship

The IAAPOC Scholarship is in honor of Sam D. Benson, C.O. who was certified by the American Board for Certification in 1981. Mr. Benson is a founding member and he became the first President of The International African American Prosthetic and Orthotic Coalition established in 1990 to promote the P & O profession in the African American Community. This scholarship is given annually to deserving students in Prosthetics and/or Orthotics education. 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 American or African Descent.
Applicant must be enrolled in a NCOPE accredited MSPO Prosthetic & Orthotic program or accepted into an NCOPE accredited MSPO P&O program.
Applicant must submit their most recent official college transcript. 

Name: ________________________________

Address: ________________________________

City: ___________________ State: _______________ Zip: ___________

Phone: ______________________ Cell: ___________________________

E-Mail: ________________________________________

Current Status: ____________________________________________________

High School Education:

School: _____________________________

City: ________________________State:_______________________

GPA: ________________________

Undergraduate Studies:

College or University ____________________________________________
Year (s) of Attendance ___________________________________________
Address: _______________________________________________________
City: _________________________ State: _________ 	Zip: ___________
Major: ______________________________ Minor: ____________________
Degree: _______________________________ GPA: ___________________
Contact Person: __________________________________________________
Contact Person’s email: ____________________________________________

Post Graduate Studies:

College or University ______________________________________________
Year (s) of Attendance _____________________________________________
Date of Graduation or Planned Graduation (MM/YY) _____________________
Address: _________________________________________________________
City: _________________________ State: __________ 	Zip: ____________
Prosthetics: _______ Orthotics: ________ GPA: ____________________
Contact Person: _____________________________________________________
Contact Person’s Email: ______________________________________________

References:

Please list two references; at least one must be a certified prosthetist or orthotist.
Name: _____________________________________ [CP, CO, CPO]
Address: __________________________ City: ______________ State: _____
Phone: _____________________, Email ____________________________

Name: _____________________________________   
Address: ___________________________ City: ______________ State: _____
Phone: ______________________, Email ______________________________

Please list any work experience you have in in O&P or rehab.

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Essay:
Please provide complete responses to both of the essay questions below. Please provide at least 400 - 500 words per response. Your application and essay will be reviewed by the IAAPOC Scholarship Committee.

Essay #1 - Identify an area in O&P that interests you, explain it and tell us why it matters to you?

Essay #2 - What are some issues/needs that African American amputees face and as a practitioner how do you plan to address some of these specific needs?

Please include a recent photo of yourself. Your application and essay will be reviewed by the IAAPOC Scholarship Committee. By submission of your essay and photo you agree to allow the IAAPOC to use your photo and essay on our web site, printed newsletter, and/or other social media.

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

Signature: ____________________________ Date: ___________

Mail Application To: Tony Thaxton Jr.,
			Treasurer, IAAPOC
			1391 Everhart St SW
			Atlanta, GA  30310-4321

Application Period for the 2022-2023 School Year has been extended to the 6th January 2023.

Please note that the scholarship application may be submitted via email. However, a hard copy of the official college transcript must be received via mail/UPS/FedEx in a sealed envelope either from the school or student.
You may email a copy of your application to treasurer@iaapoc.org and cc a copy to thaxton.jr@comcast.net.