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* 1. Name of Applicant

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* 3. Are you currently an MGMA State Chapter member?

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* 4. Current Employment

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* 5. Please select which option best describes your situation.

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* 6. Why do you think it is important to come to the Mid-Atlantic MGMA 2025 Regional Summit?

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* 7. I acknowledge these scholarships are available to those in need who do not have support from their institutions.

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