2018-2019 ORSA Extramural Scholarship Application
Any student official at an ORSA institution is eligible to apply for the extramural scholarship. ORSA will fund include the following: NIRSA Regional/National tournament travel assistance, NIRSA/Region III/ORSA Extramural workshop registration/travel assistance, or other extramural events.

Please note that scholarships awarded will be given on a reimbursement basis, and are contingent upon their attendance and actual cost incurred during the trip. Applicants are required to submit original copies of receipts if they receive a scholarship.

Applications applicable to any Fall extramural events must be submitted by Thursday, December 6th at 12:00 pm.

Please contact Aaron Brooks (amb72@uakron.edu) with any questions.

Email address *
Name (First and Last) *
Your answer
Email *
Your answer
Phone Number *
Your answer
Mailing Address
Your answer
Current Institution *
Your answer
Year in school *
What extramural event are you requesting funds for? *
Your answer
How do you plan on traveling to this event? *
Your answer
What is the length of this event? Please include the dates. *
Your answer
Total cost of event (indicate if this is an estimated amount, or actual amount incurred) *
Your answer
Scholarship amount requested: *
Please breakdown your cost into travel cost, food cost, hotel cost, and other miscellaneous cost.
Your answer
Does your institution have funding available to you? *
Potential forms of funding considerations: stipends, travel assistance, meal assistance.
Your answer
Do you belong to any official's association (school affiliated or local)? If yes, does this association have funding available to you? *
Your answer
Please list the sports you officiate, the length of time you have been officiating and if you are certified. *
Your answer
Briefly explain how this scholarship will benefit you as an official and as a student employee of your institution. *
Your answer
What experience and/or development do you hope to gain from the use of this scholarship and attendance at this event? *
Your answer
Please provide the name and contact information (email and phone) of a professional staff reference at your institution. *
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of University of Dayton. Report Abuse - Terms of Service