IAHPERD Member Travel Scholarship Form
All Applications must be received by December 23, 2016. Applications must be complete for full consideration.
Email address *
NAME *
MAILING ADDRESS *
PHONE *
EMAIL ADDRESS *
SCHOOL DISTRICT & BUILDING *
ADMINISTRATOR & EMAIL ADDRESS *
CURRENT IAHPERD MEMBER *
YEARS OF IAHPERD MEMBERSHIP *
CONFERENCE/WORKSHOP ATTENDING *
CONFERENCE/WORKSHOP DATES *
CONFERENCE/WORKSHOP LOCATION *
TRAVEL SCHOLARSHIP AMOUNT REQUESTED *
In what capacity have you been involved with IAHPERD? (Limit 50 words) *
Why have you chosen this Conference/Workshop? (Limit 50 words) *
How will this Conference/Workshop benefit you professionally? Will it benefit Iowa AHPERD? (Limit 50 words) *
Are other funding sources available? If not fully funded, where will remaining funds come from? (Limit 50 Words) *
Have you received Travel Scholarship or IAHPERD Grant Funds Previously? If so, how much, for what, and when? (Limit 50 Words) *
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