Drag file to upload or click to browse\r\n
{{\r\n item.name\r\n }}
\r\n\r\n I have read and understand the requirements of the Wyoming State Loan Repayment Program,\r\n and affirm that I meet the qualifications for participation in the Wyoming State Loan Repayment Program.\r\n
\r\n\r\n I certify that the information provided is accurate and complete to the best of my knowledge and that I am applying for Wyoming State Loan Repayment of loans\r\n incurred solely for the costs of education, including reasonable living expenses, leading to a degree in an eligible healthcare profession\r\n
\r\n\r\n I hereby authorize the Wyoming Department of Health, Public Health Division,\r\n Office of Rural Health to contact the listed employer and relevant licensing authorities to confirm my eligibility for this program.\r\n
\r\nAs the healthcare provider applicant, by clicking \"submit application, I certify all the above information is correct
\r\n\r\n I certify that the above named provider works/will work full-time\r\n (at least 40 hours per week) for at least 45 weeks per year in accordance with the WY-SLRP Full-Time Clinical Practice Requirements.\r\n
\r\n\r\n\r\n I have read and understand the requirements of the Wyoming State Loan Repayment Program, and affirm that the listed practice site(s)\r\n in this application meet(s) the qualifications for participation in the Wyoming State Loan Repayment Program\r\n
\r\n\r\n I certify that the information provided is accurate and complete to the best of my knowledge,\r\n and that our agency has successfully completed negotiations for employment with the healthcare provider.\r\n
\r\n{{item.name}}
\r\n