Fiscal Year 2009

• Please Note: AMENDMENT APPLICATION DEADLINE — Your National Health Service Corps (NHSC) Loan Repayment Program (LRP) amendment application must be postmarked no later than 180 days prior to the end of your current service commitment. If you do not submit your application at least 180 days before the end of your current service commitment, based on the end date currently reflected in our records, the NHSC program cannot guarantee your application can be processed and could 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 2009 (October 1, 2008, through September 30, 2009) 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:

1. Fiscal year 2009 Contract to Extend and Amend the NHSC LRP Contract
2. Fiscal Year 2009 Verification of Employment Intentions to Amend the NHSC LRP Contract
3. Fiscal Year 2009 Loan Payment History (refer to cover letter below)
4. Fiscal Year 2009 Loan Information and Verification Form
5. Fiscal Year 2009 Payment Information Form for Direct Deposit into a Checking or Savings Account
6. Fiscal Year 2009 Authorization to Release Information
7. Fiscal Year 2009 Contract Amendment Package Check list

Participants must complete the entire application and send it to:

Division of Applications and Awards
National Health Service Corps Loan Repayment Program
5600 Fishers Lane, Room 8-37, Rockville, MD 20857

Effective October 1, 2007, 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 2009 Cover letter: PDF (41 KB)
• Fiscal Year 2009 Contract to Extend and Amend the NHSC LRP Contract: PDF (24 KB)
• Fiscal Year 2009 Verification of Employment Intentions: PDF (15 KB)
• Fiscal Year 2009 Loan Information and Verification Form: PDF (23 KB)
• Fiscal Year 2009 Payment Information Form for Direct Deposit into a Checking or Savings Account: PDF (24 KB)
• Fiscal Year 2009 Authorization to Release Information: PDF (11 KB)
• Fiscal Year 2009 Contract Amendment Package check list:  PDF (19 KB)