Home » Faculty Loan Repayment Program: Application Checklist

Faculty Loan Repayment Program: Application Checklist

Health Resources & Services Administration

The Faculty Loan Repayment Program provides up to $40,000 in loan repayment assistance. In exchange, you commit to two years of full or part-time service as a faculty member at an eligible health professions school. 

The application deadline is Thursday, July 3 at 7:30 p.m. ET. Watch the recording of our application assistance webinar and review our application checklist to prepare your application.


Application Checklist

  • of U.S. Citizenship Document – Acceptable documents include a U.S. birth certificate, an unexpired U.S. Passport ID page or U.S. Passport Card, a Certificate of Citizenship, a Naturalization Certificate, and/or a Permanent Resident Card (Green Card). A social security card, REAL ID, or marriage license are NOT acceptable as proof of citizenship.
  • Proof of Disadvantaged Background – The document indicates that you were economically or environmentally disadvantaged and must be signed by a program or school administrator. 
  • Health Professions Degree or Certificate – The document must include your name, type of degree, date conferred, and signature by an authorized program director, dean, or other school official. If you are in your final year of study, ask for an official letter that indicates your expected graduation.
  • Academic Transcripts – Submit an official or unofficial transcript from each college or health professions school for all coursework directly related to your degree(s) or certificate(s). Your transcript must be legible and include your dates of attendance and courses taken.
  • Institution Employment/Loan Repayment Verification Form – Contact your employer or human resources officer to complete this form to confirm your active employment at the institution. 
  • Employment Contract/Letter of Employment – Submit a copy of your contract or letter of employment to validate your employment status with your academic institution, and include your effective start date, end date, and your base salary. The document must also show that you will work at the institution by July 3, 2025 for a minimum of two more years.
  • Loan Repayment Match/Request for a Waiver of the Loan Repayment Match – Include a copy of your employer’s:
    • written agreement to pay your loan repayment amount equal to the loan repayment amount OR
    • request for a full waiver to match the loan repayment amount with supporting documentation citing undue financial hardship OR
    • request for a partial waiver requirement to match the loan repayment amount with supporting documentation citing undue financial hardship.
  • Authorization to Release Information Form – Download this form from the online application, fill it out, sign it, and upload it to the application with a handwritten or electronic signature.
  • Loan Documentation – All loan documentation must be from the lender and include your name, lenders’ name(s) and account number(s). 

For a complete list of required application materials, review pages 21-27 of the Application & Program Guidance.


Join Our Application Assistance Q&A Session

Tuesday, June 17
10:30 a.m. – 12:00 p.m. ET
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