Applications MUST be received at least 90 days before the contract end date. Applications received later than this deadline will not be eligible for consideration.

NHSC LRP participants who are completing their contract during Fiscal Year 2006 (October 1, 2005, through September 30, 2006) 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.

Participants must complete the entire application and send it to:

There are six items that must be completed. Download the complete LRP Contract Amendment FY06 application as one Acrobat/pdf file or download the six individual files:

1. Contract to Extend and Amend the NHSC LRP Contract (Acrobat/pdf)
2. Verification of Employment Intentions to Amend the NHSC LRP Contract (Acrobat/pdf)
3. Loan Payment History (refer to cover letter) (Acrobat/pdf)
4. Loan Information and Verification Form (Acrobat/pdf)
5. Payment Information Form for Direct Deposit into a Checking or Savings Account (Acrobat/pdf)
6. Authorization to Release Information (Acrobat/pdf)

Effective October 1, 2005, award amounts for amendment contracts will be as follows: