Submit electronic NHSC LRP Application and Print out, sign & submit a paper copy of electronic application

January 31, 2009 (postmark date)

Submit Community Site Information Form(s)

January 31, 2009 (postmark date)

Submit Loan Information and Verification Form(s)

January 31, 2009 (postmark date)

Submit Biographical Statement

January 31, 2009 (postmark date)

Submit electronic BCRSIS Banking Information and Print out, sign & submit Receipt of BCRSIS Banking Information

January 31, 2009 (postmark date)

Submit NHSC LRP Checklist

January 31, 2009 (postmark date)

Submit Privacy Act Release Authorization Form (if applicable)

January 31, 2009 (postmark date)

Submit Applicant’s Certification of Accuracy of Information Provided Form

January 31, 2009 (postmark date)

Submit Certification Regarding Debarment, Suspension, Disqualification and Related Matters Form

January 31, 2009 (postmark date)

Submit Signed and Dated NHSC LRP Contract

January 31, 2009 (postmark date)

Submit Authorization to Release Information Form

January 31, 2009 (postmark date)

Submit Proof of U.S. Citizenship or U.S. National

January 31, 2009 (postmark date)

Submit Documentation of Status as a Member of Reserve Component of the Armed Forces (if applicable)

January 31, 2009 (postmark date)

Submit Letter from Entity to which Existing Service Obligation is Owed (if applicable)

January 31, 2009 (postmark date)

Submit Two (or, if applicable, Four) Letters of Reference (dated after October 1, 2008)

January 31, 2009 (postmark date)

Submit Current Resume/Curriculum Vitae

January 31, 2009 (postmark date)

Submit Disadvantaged Background Documentation (if applicable)

January 31, 2009 (postmark date)

Submit Exceptional Financial Need Documentation (if applicable)

January 31, 2009 (postmark date)

Submit Copy of the Original Loan Applications, Promissory Notes, Disclosure Statements, Truth-in-Lending Statements

January 31, 2009 (postmark date)

Submit Copy of Current Account Statements for each loan submitted

January 31, 2009 (postmark date)

Submit Copy of Your Specialty Board Certification or Residency Completion Certificate (Exception: physicians/dentists in last year of residency submit letter of good standing from Residency Program Director)

January 31, 2009 (postmark date)

Submit Copy of Your Health Professional Degree or Certificate

January 31, 2009 (postmark date)

Submit Copy of Your National Certification (PAs, NPs,  NMs, PNSs, LPCs, MFTs)

January 31, 2009 (postmark date)

Submit Copy of Your Permanent License in the State of Practice Exception:  physicians/dentists in last year of residency submit copy of your permanent license in the State of Practice by August 15, 2008 (postmark date)

January 31, 2009 (postmark date)

Submit Copy of Your National Board Examination Results (SWs, DHs, HSPs)

January 31, 2009 (postmark date)

Submit copy of the National Practitioner Data Bank (NPDB) “Response to Your Self-Query” report and associated documents.

January 31, 2009 (postmark date)

Submit copy of the Healthcare Integrity Protection Data Bank (HIPDB) “Response to your self-Query” report and associated documents.

January 31, 2009 (postmark date)

** New physicians and dentists only: Submit letter of good standing from Residency Program Director

January 31, 2009 (postmark date)

**New physicians and dentists in last year of residency only: Submit copy of Residency Completion Documentation/Certificate

July 7, 2009

Last Date to Submit a Request to Terminate an NHSC LRP Contract

August 17, 2009

Notify Applicants of Award

Ongoing, January to September 30,  2009

Fund Qualified Applicants

January to September 30, 2009

Notify Applicants of Non-Selection for an Award

December to September 30, 2009

Complete All Awards

September 30, 2009