The purpose of this application is to apply for a registration scholarship to the 2012 Western Museums Association (WMA) Conference in Palm Springs, CA October 21-24, 2012. Scholarships are provided by WMA and selected by CAM’s Multicultural Emerging Professionals (MEP) Committee. Each scholarship includes a complimentary full three-day registration to the conference valued at $400. The scholarship does not include lodging, travel expenses, workshops, meals, or evening events.

Question Title

* 1. Applicant's Name:

Question Title

* 2. Applicant's Title:

Question Title

* 3. Museum/Organization (if applicable):

Question Title

* 4. Mailing Address:

Question Title

* 5. City, State, and Zip Code:

Question Title

* 6. Supervisor's/Professor's Name and Title:

Question Title

* 7. Applicant's Email Address:

Question Title

* 8. Applicant's Daytime Phone Number:

Question Title

* 9. Are you a resident of California?

Question Title

* 10. I certify that:
(Please check all that apply to you or your museum. This information will help the Scholarship Committee determine your eligibility for a scholarship.)

Question Title

* 11. If you are a graduate student, please describe your commitment to the museum field. Include information about the graduate program you are currently enrolled in.
(If you are not a graduate student, please skip this question.)
Please limit your response to 75 words or less.

Question Title

* 12. Please provide a personal statement. Describe how you and/or your museum will benefit from your attendance at the 2012 WMA Conference.

Please limit your statement to 100 words or less.

If you would like a copy of this completed form for your records, please print prior to clicking "Submit."

You will receive an email Monday, June 25th confirming the receipt of your application and you will be notified about the status of your submission before July 31st (Early Bird Registration Deadline for WMA’s Annual Meeting).

T