Harvey Lillard Scholarship Application

Chiropractic College Attending *

Chiropractic College Attending

Enter required value Keiser University Life Chiropractic College West Life University Northwestern Health Sciences University Logan University Texas Chiropractic College Parker University University of Bridgeport School of Chiropractic Palmer College of Chiropractic - West Palmer College of Chiropractic - Florida Cleveland University - Kansas City D'Youville University National University of Health Sciences Northeast College of Health Sciences Palmer College of Chiropractic - Davenport Southern California University of Health Sciences Sherman College of Chiropractic University of Western States

What Quarter/Trimester Are You? *

What Quarter/Trimester Are You?

Enter required value Tri 5 Qtr 7 Qtr 14 Tri 7 Qtr 5 Tri 3 Tri 2 Tri 10 Qtr 2 Qtr 4 Qtr 10 Qtr 3 Qtr 8 Qtr 6 Qtr 12 Qtr 9 Qtr 11 Qtr 13 Tri 1 Tri 6 Tri 8 Tri 4 Tri 9 Qtr 1

First Name *

Last Name *

Address Line 1 *

Address Line 2 *

City *

State *

Enter required value

Postal Code *

Email *

Educational Background *

Enter - College or University Name / Years Attended / Degree

Educational Background *

Enter - College or University Name / Years Attended / Degree

Enter N/A if none.

Educational Background *

Enter - College or University Name / Years Attended / Degree

Enter N/A if none.

Extracurricular Activities *

Enter - Organization Name / Year(s) Active/Position Held  

Extracurricular Activities *

Enter - Organization Name / Year(s) Active/Position Held  

Enter N/A if none.

Extracurricular Activities *

Enter - Organization Name / Year(s) Active/Position Held

Enter N/A if none.

Extracurricular Activities *

Enter - Organization Name / Year(s) Active/Position Held

Enter N/A if none

Extracurricular Activities *

Civic/Religious/Community / Year(s) Active/Position Held

Extracurricular Activities *

Enter - Civic/Religious/Community / Year(s) Active/Position Held

Enter N/A if none.

Essay Questions *

1. Purpose & Motivation

What inspired you to pursue a career in chiropractic care, and how have your personal experiences shaped your vision for your role in the profession?

Essay Questions *

2. Service & Impact

Describe a moment when you made a meaningful difference in someone’s health or well-being. How does this experience influence the way you plan to serve your community as a chiropractor?

Essay Questions *

3. Leadership & Future Contribution

The chiropractic field continues to evolve. What contributions do you hope to make to the profession—clinically, academically, or through advocacy—and how will this scholarship help you achieve those goals?

Consent to the code of ethics policy *

This serves as my personal and truthful statement that I have not been found in violation of the student code of ethics while a student at any chiropractic college, and further give the ABCA Scholarship Committee Permission to verify my statement.