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APPLICATION FOR WFOA SCHOLARSHIP

Applications will be considered by order of need, by order of date received, and within the limitations of scholarship funds available. First consideration will be given to registration fees. All applicants must be members of WFOA.

Last Name: *

First Name: *

Middle Name:

Email: *

Employer:

Phone:

Address

City, State, Zip:

Your Title:

Part Time

Full Time

Primary Duties:

Name of class, seminar, or conference which you would attend if awarded scholarship.

Course/Conference

Location

Date

Sponsored By

Reason for Attendance

Scholarship are primarily awarded for tuition or registration only, however additional funds for travel expenses may be awarded depending on need, circumstances, and scholarship funds available in the current year.

Total amount of scholarship you are requesting:

Registration

Lodging

Travel

Other

(Describe)

Will your entity help finance part of the cost of you attending this class, seminar or conference?

Yes

How Much?

Have you ever previously attended the event?

Yes

How was it funded?

Have you recieved previous WFOA Scholarships?

Yes

When?

How Much?

You should attach to this application a statement from your Mayor, Council, Finance Director, or Chief Administrator demonstrating their support in your attendance to the educational opportunity, explaining the benefit they believe this opportunity would have for your entity, and confirming that scholarship moneys are necessary to enable you to attend this event.

I hereby apply for scholarship funds to attend , and attest that the information submitted in and with the application is true and accurate to the best of my knowledge.

Signature of Applicant: *

Date:

Please submit your application at least three weeks prior to the date of the class, seminar, or conference you are hoping to attend.