ISPS-US Scholarships
ISPS-US is committed to increasing accessibility to our programs for people from communities who have traditionally experienced oppression, and who may otherwise be excluded due to financial circumstance. ISPS-US has scholarship funding to discount membership dues and conference attendance. Funds are limited and subject to availability and will be made available on a first-come, first-serve basis for eligible individuals. Completion of this form is not a guarantee to receive funding. You will be contacted regarding your request as soon as possible. Please email contact@isps-us.org with any questions.


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Email *
Date of form completion *
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Title *
Full Name *
Email Address *
Type of Scholarship Being Requested: *
Required
 If you are applying for a conference scholarship, are you hoping to attend online or in-person?
(leave blank if you are applying for a membership scholarship)
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ISPS-US low-income scholarships are open to those earning 200% OR LESS  of the Federal Poverty Level (FPL). Please visit the following website to calculate your household income according to FPL: https://www.healthinformatics.dphe.state.co.us/NonAuthenticated/FPLCALC/ *
Required
If applying for a scholarship, are you able to afford the full cost of a membership? 
(the full cost of a monthly membership is $6.67 a month)
*
Please provide a brief statement describing your interest in the event / becoming an ISPS-US member *
A copy of your responses will be emailed to the address you provided.
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