AAGP Foundation Annual Conference Scholarship Application Form

What scholarship are you applying for (applicants can only apply for one)? The 2010 Conference Scholarships are due June 30, 2010 at midnight, CST.*

AAGP Foundation Scholarship (open to the general public and AAGP members)
Dawn Bluhm Scholarship (applicants must be residents of Illinois and employed by a non-profit)
V.C. League Scholarship (applicants must be members of the Central Indiana Chapter of AAGP)

First Name*

Middle Name or Initial

Last Name*

E-Mail Address*

Organization Name

Street - Line 1*

Street - Line 2

City*

State*

Postal Code*

Country

Daytime Telephone*

Evening Telephone

Fax Number

Are you currently a member of AAGP?*

YesNo

Have you attended an AAGP Conference in the past?*

YesNo

Do you adhere to the AAGP Code of Ethics?*

Find the AAGP Code of Ethics here.
YesNo

How will you use your conference experience to enhance your growth as a grant professional?*

(Please limit your response to no more than 250 words.)

How will your attendance at this conference benefit your organization? Please include a brief description of your organization.*

(Please limit your response to no more than 250 words.)

What is your background in the grants field?*

(Please limit your response to no more than 250 words.)

What other factors/needs would you like us to consider in making this decision?*

(Please limit your response to no more than 250 words.)

Senior Officer's Name*

Please include the first and last name and contact information of the most senior member of your agency (yourself if self-employed) for verification of the information listed. He/she will receive an e-mail copy of your conference scholarship application.

Senior Officer's Title*

Senior Officer's telephone*

Senior Officer's e-mail*

Reference's Name*

Please include the first & last name and contact information for a professional reference, either in the grants field or in your agency. He/she will receive an e-mail copy of your conference scholarship application.

Reference's Title*

Reference's telephone*

Reference's e-mail*

I have read the Terms of Application on the bottom of this page and by submitting this application for, I signify my agreement thereto.

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