2020 CCIH Scholarship Reference Form
Thank you for your willingness to be a professional or academic reference for an applicant for the 2020 CCIH Conference General Scholarship

As a reference, we ask that you answer the questions below by February 7, 2020. Any submissions after that date will not be considered and the candidate's application will be considered incomplete.

Submit any questions to scholarships@ccih.org.

You can find more information about CCIH and our Annual Conference at www.ccih.org.
Who is this reference for?
Your answer
Contact Information
Full Name *
Your answer
Job Title and Organization *
Your answer
Phone Number *
Include country code if outside USA.
Your answer
Email Address *
Please enter your address used for professional correspondence.
Your answer
Relationship to Applicant *
e.g. supervisor, professor, colleague, etc
Your answer
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