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IAHPERD Member Travel Scholarship Form
All Applications must be received by December 23, 2016. Applications must be complete for full consideration.
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* Indicates required question
Email
*
Your email
NAME
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Your answer
MAILING ADDRESS
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Your answer
PHONE
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Your answer
EMAIL ADDRESS
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Your answer
SCHOOL DISTRICT & BUILDING
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Your answer
ADMINISTRATOR & EMAIL ADDRESS
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Your answer
CURRENT IAHPERD MEMBER
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Choose
YES
NO
YEARS OF IAHPERD MEMBERSHIP
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Your answer
CONFERENCE/WORKSHOP ATTENDING
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Your answer
CONFERENCE/WORKSHOP DATES
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Your answer
CONFERENCE/WORKSHOP LOCATION
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Your answer
TRAVEL SCHOLARSHIP AMOUNT REQUESTED
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Your answer
In what capacity have you been involved with IAHPERD? (Limit 50 words)
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Your answer
Why have you chosen this Conference/Workshop? (Limit 50 words)
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Your answer
How will this Conference/Workshop benefit you professionally? Will it benefit Iowa AHPERD? (Limit 50 words)
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Your answer
Are other funding sources available? If not fully funded, where will remaining funds come from? (Limit 50 Words)
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Your answer
Have you received Travel Scholarship or IAHPERD Grant Funds Previously? If so, how much, for what, and when? (Limit 50 Words)
*
Your answer
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