PNACAC/RMACAC/WACAC Professional Development Scholarship Application
The Pacific Northwest, Rocky Mountain and Western ACAC executive boards invite colleagues to apply for professional development funds to attend the 2019 SuperACAC Conference. These scholarships are intended to off-set the costs of conference registration and travel to Phoenix, AZ May 20-22, 2019.

Applications and nominations from others are welcomed. Preference will be given to applicants/nominees who represent one or more of the following:

1. High school or community college counselors/advisors who serve under-represented populations, including but not limited to ethnic/racial minority students, rural students, public school students, and transfer students.
2. First-time NACAC Affiliate (regional) Conference attendee/have not participated in a previous regional conference.
3. Educators who cannot/do not attend the NACAC Annual Conference.

Should you have questions about the application or nomination process, please contact the Scholarship Committee chairperson for your primary affiliate:
Western ACAC--Alicia Ortega,
Pacific Northwest ACAC--Stephen Russell,
Rocky Mountain ACAC--Tyler Cegler,

While it is not a requirement to be a member of your regional affiliate to apply for a scholarship, if you are awarded funding you must join the organization prior to registering for the conference.

Applications are due by 11:59pm PST on November 21, 2018.

With which affiliate do you primarily associate? *
Applicant's First Name *
Your answer
Applicant's Last/Family Name *
Your answer
Applicant's Job Title *
Your answer
Applicant's Institution/Organization *
Your answer
Applicant's City of Employment *
Your answer
Applicant's State of Employment *
Has the applicant attended a NACAC Affiliate (regional) Conference previously? *
Has the applicant previously received a scholarship to attend a NACAC Affiliate (regional) Conference? *
How many years has the applicant worked in college admissions counseling? *
Your answer
How many years has the applicant worked at their current school/organization? *
Your answer
Describe the demographics as well as the college-going rates/institutional types of the applicant’s student populations? *
Your answer
What are the applicant's primary job responsibilities? *
Your answer
Describe how the applicant contributes to their students, school, and the professional community. How would the applicant benefit from receiving a scholarship to attend the SuperACAC Conference? *
Your answer
Is the applicant applying for (choose all that apply) *
If awarded a scholarship to attend the Phoenix SuperACAC Conference, what mode of transportation would the applicant use? *
Is there anything additional that the selection committees should know about the applicant?
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service