Scholarship Application

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Name *

Mailing Address *

E-mail Address *

Phone Number *

Please mark your current certifications. (Check all that apply) *

National Certification (RID, NAD)

Utah State Certification (Novice, Professional, Master)

EIPA Certification

I am not currently certified

Other:

Required

Are you a member of RID? *

*Applicants must be a member in good standing with UTRID and RID

Are you a member of UTRID? *

*Applicants must be a member in good standing with UTRID and RID

How much are you requesting? (max $500.00) *

What are you requesting the funds for? *

In 250 words or less, or a video in ASL 5 minutes or less, please describe how these funds, used for this purpose will benefit you as an interpreter. (If using video please provide an accessible link here.) *

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