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Contract Amendment Application
Fiscal Year 2007
- Please
Note: AMENDMENT APPLICATION DEADLINE—
Your NHSC LRP amendment application must be postmarked
no later than 90 days prior to the end of your current service
commitment. Failure to submit your application at least
90 days before the end of your current service commitment, based
on the end date currently reflected in our records, will
result in your application being denied. If you are not
sure what your service commitment end date is, please contact
the NHSC at 1-800-221-9393.
NHSC LRP participants
who are completing their contract during Fiscal Year 2007 (October
1, 2006, through September 30, 2007) may be eligible to amend
their contract to receive loan repayment assistance for an additional
year of service, subject to the availability of appropriated funding.
There are
7 items that must be completed:
- Fiscal
year 2007 Contract to Extend and Amend the NHSC LRP Contract
- Fiscal
Year 2007 Verification of Employment Intentions to Amend the
NHSC LRP Contract
- Fiscal
Year 2007 Loan Payment History (refer to cover letter below)
- Fiscal
Year 2007 Loan Information and Verification Form
- Fiscal
Year 2007 Payment Information Form for Direct Deposit into a
Checking or Savings Account
- Fiscal
Year 2007 Authorization to Release Information
- Fiscal
Year 2007 Contract Amendment Package Check list
Participants
must complete the entire application and send it to:
The Division
of the National Health Service Corps
Application and Award Branch
5600 Fishers Lane, Room 8 A-55, Rockville, MD 20857
Effective
October 1, 2005, award amounts for amendment contracts will be
as follows:
- For a 3rd
year of assistance, participants will receive up to $35,000;
- For a 4th
year of assistance, participants will receive up to $35,000;
- For a 5th
year of assistance, participants will receive up to $25,000;
- For a 6th
year of assistance, participants will receive up to $20,000;
- For years
7 and beyond, participants will receive up to $15,000.
- Fiscal
Year 2007 Cover letter: PDF
- Fiscal
Year 2007 Contract to Extend and Amend the NHSC LRP Contract:
PDF
- Fiscal
Year 2007 Verification of Employment Intentions: PDF
- Fiscal
Year 2007 Loan Information and Verification Form: PDF
- Fiscal
Year 2007 Payment Information Form for Direct Deposit into a
Checking or Savings Account: PDF
- Fiscal
Year 2007 Authorization to Release Information: PDF
- Fiscal
Year 2007 Contract Amendment Package check list: PDF
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Minnesota
NHSC Clinicians Wrap Rural Community in Good Mental Health
For the last 15 years, Crookston, Minnesota, has had more than its fair share of floods, droughts, and other natural disasters. As a result, the hardy and resilient population of farming families finds itself struggling under the burden of foreclosures, financial crisis, and the resulting emotional, mental, and stress-related problems.
Read more
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