Holtshopple Scholarship
Each year a complimentary registration to WSPRA's Annual Fall Conference will be given in
Allan Holtshopple's memory.


Criteria:
• Must be a new member within the past two years.
• Must be an individual who demonstrates community involvement.

Applications due Friday, October 20, 2017
Nominee Information
Name *
Your answer
Title
District/Organization *
Your answer
Address *
Your answer
City *
Your answer
State *
(two-letter postal code)
Your answer
Zip *
Your answer
Telephone
(Business)
Your answer
Telephone
(Home)
Your answer
E-Mail Address
Your answer
Is this a self nomination?
Question 1 *
List your community involvement/service (organizations and other volunteer activities)
Your answer
Question 2 *
Reflect on one successful PR project during the last year. What made it successful?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.