Welcome to the Provider Scholarship Application

The TN Chapter HFMA Fall Institute is October 29-30, 2019 at the Park Vista in Gatlinburg, TN. We have a limited number of provider scholarships available. We will cover the registration and hotel (max of one night) for provider representatives. Therefore, we are asking that if you are interested and you can attend the meeting on a scholarship that you complete the attached application. 

Application should be received by September 14, 2019 at noon. 

Scholarship determinations will be awarded by the scholarship committee and awards are not subject to the direct influence or request of a TN HFMA Sponsor. This protects providers and sponsors from any undue influence compliance concerns. 

We look forward to seeing you at the 2019 Fall Institute. 


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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What Company do you work for?

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* 4. What is your title?

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* 5. Email

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* 6. Best number to contact you:

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* 7. Are you an HFMA member?

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* 8. Type of Provider Organization 

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* 9. Please indicate what you will need covered: 

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* 10. Please describe in 50 words or less why you should receive a scholarship for this event:

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* 11. By applying for the scholarship program, you confirm that
  • My registration cost nor accommodation cost is not being reimbursed by my employer
  • I am employed by the above noted provider organization
  • I understand that a limited number of awards are available
  • I understand awards are subject to approval by chapter leaders
  • If for some reason I am not able to attend the event after the scholarship is awarded, I will notify the Scholarship representative so that my scholarship can by used by another applicant
  • I may be asked for comments related to my experience for a highlight on the TN Chapter website

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