2012 WMA Conference - Discounted Registration Application Survey

The purpose of this application is to apply for a discounted registration to the 2012 Western Museums Association Conference in Palm Springs, CA October 21-24, 2012. Discounted Registrations are provided by WMA and recipients are selected by CAM’s Multicultural Emerging Professionals (MEP) Committee. Each award will grant the recipient a $200 discounted full conference registration. The discount is not valid for lodging, travel expenses, workshops, meals, or evening events.

1.Applicant's Name:(Required.)

2.Applicant's Title:

3.Museum/Organization (if applicable):

4.Mailing Address:(Required.)

5.City, State, and Zip Code:(Required.)

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

7.Applicant's Email Address:(Required.)

8.Applicant's Daytime Phone Number:(Required.)

9.Are you a resident of California?(Required.)

yes

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.)(Required.)

I am an employee or volunteer of the museum listed above.

The museum is a nonprofit organization or a governmental entity located in California.

I am an Individual or Institutional member of CAM.

I have less than five years experience in the museum field.

I am a graduate student.

I am of Latino, African, Asian, Native American, and/or Pacific Islander descent.

My museum has an annual operating budget of $250,000 or less.

My museum has an annual operating budget of $250,001 to $500,000.

My museum has an annual operating budget over $500,000.

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.

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.(Required.)

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).