AZAND Scholarship Application
Scholarship Amounts: $250 for each scholarship

Due Date: February 25, 2020

Items you need to complete this application are:

• Resume
• Letter of recommendation from internship director
• Additional letter(s) of recommendation (optional)

Recipients will be notified by the AZAND Awards Chair on or before March 25. If you have questions, please email us at
Applicant Information
Name *
Your answer
Academy Membership Number *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Email Address *
Your answer
Phone *
Your answer
Internship Program Name *
Your answer
Scholarship Information
Susan Grogan Memorial Scholarship - Interns currently enrolled in an Arizona-based non-community-emphasis dietetic
internship are eligible to apply.

Morissa White Miller Memorial Scholarship - Interns currently enrolled in a community nutrition/public health emphasis dietetic
internship program are eligible to apply.
Select Scholarship for which you are applying: *
Personal Statement *
In 300 words or less, describe why you deserve this award. Include achievements, honors, and state or district academy activities
Your answer
By writing my name below, I confirm I am virtually signing this document.
Your answer
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