Alaska Maternal Child Health & Immunization Conference - 2018 Travel Scholarship Application

The Alaska MCH and Immunization Conference is organized by the Alaska Native Epidemiology Center (EpiCenter) and the Alaska Division of Public Health, Section of Women's, Children's, and Family Health. We are excited to provide an opportunity for rural and urban Alaska health professionals to come together to learn about best practices, tools for the prevention of key and emerging maternal child and family health issues in Alaska. This year’s conference theme is Advancing Wellness Across the Lifespan.
 
For details and updates about this conference please visit the website.

Travel scholarships are available and may include:
  • Registration
  • Transportation
  • Lodging
Scholarships will cover approved travel expenses as allowed by ANTHC's policy on external travel. All completed travel scholarship applications must be received by Sunday July 29, 2018. All applicants will be notified by Friday, August 3, 2018 as to whether or not they were awarded a travel scholarship. 

If you have any questions, please email anepicenter@anthc.org.

Please note, you can start this survey and finish it at a later time as long as you use the same device and web browser you first used to start the survey.
Please fill in all of the following fields in order to apply for a travel scholarship, and press "SUBMIT APPLICATION" when complete. *Please note a Letter of Support is required to complete your application.
Please let us know what support you are requesting:

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* 1. Please let us know what support you are requesting:

Contact Information

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* 2. Contact Information

Please indicate if you are:

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* 3. Please indicate if you are:

How long have you worked at your organization:

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* 4. How long have you worked at your organization:

Please answer each of the following questions:

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* 5. Please answer each of the following questions:

  Yes No
Do you identify as Alaska Native and/or American Indian?
Do you work or attend school outside the Anchorage/ Mat-Su area?
Are you a student?
Personal Statement
Provide a brief explanation of your interest in attending this conference and how attending will impact your work or your studies.

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* 6. Personal Statement
Provide a brief explanation of your interest in attending this conference and how attending will impact your work or your studies.

Letter of Support

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* 7. Letter of Support

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