Student Scholarship Application: APAC Forum on Quality Improvement in Health Care
Thank you for your interest in the APAC Forum on Quality Improvement Health Care on September 20-21, 2012 in Auckland, New Zealand. A limited number of scholarships for reduced registration fees are available for full-time students. Scholarships will be rewarded on a first-come, first-served basis. Please note that you are responsible for your travel, food and accommodation costs associated with attending the program.

To be eligible for this scholarship, you must be a full-time student.
Applicant First & Last Name *
Your answer
Applicant Email Address *
All correspondence will be sent here
Your answer
Are you a full-time student? *
Name of University/College *
Your answer
Major/Program of Study *
(Medicine, Nursing, Pharmacy, Engineering, etc.)
Your answer
Year of Graduation
Your answer
Are you part of the IHI Open School community? *
If yes, what is the name of your Chapter?
Your answer
Who referred you to this event?
First & last name
Your answer
Please include any further information or comments about yourself that you would like to share.
(Examples: Why you should be selected, your improvement experience, future plans, etc)
Your answer
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