Wufoo
2023 Regional Conference Scholarship Application
Must be received no later than December 13, 2022.
Follow these steps to apply for a scholarship to one of this year's regional conferences.
Nominators only need to complete steps 1 & 2.
1
About the Applicant
2
Nominator Information
3
Why should you be awarded the scholarship?
4
Demographic information
Applicant/Nominee Name
*
First
Last
Applicant/Nominee Organization
*
Applicant/Nominee Email Address
*
Is the individual currently an URMIA institutional member? If not, the individual is not eligible to apply or be nominated. If you are not sure, search the
online directory
before finishing.
*
Yes
No
Applicant/Nominee Phone Number (optional)
Which regional conference would the individual most likely attend? Please indicate all that apply.
Feb. 5-6 | Southeastern in Orlando
March 1-2 | Western in Anaheim
April 10-11 | Northeastern in Boston
Check the appropriate statement:
*
I am nominating someone for a scholarship
I am applying for a scholarship
1
/
4
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