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Early Career PA Application for Travel Funding to Attend the 2026 REPRESENT! NCCPA Summit

The REPRESENT! NCCPA Summit is a biennial gathering of physician assistants (PAs), PA faculty, PA students, organizational leaders, physicians, and employers committed to increasing the representation of historically underserved groups within the PA profession. The Summit will take place September 18–19, 2026, in Atlanta, GA.

The nccPA Health Foundation is pleased to directly support this event by providing travel funding for up to five (5) early career PAs to participate in the Summit. For this activity, the Health Foundation defines early career PAs as individuals who received their initial board certification from NCCPA on or after June 1, 2023.

We look forward to reviewing your application, and travel funding recipients are scheduled to be announced in late July.
1.Full Name & Credentials(Required.)
2.NCCPA ID # (to verify date of initial certification)(Required.)
3.Email address(Required.)
4.Contact number(Required.)
5.City, State(Required.)
6.Describe why you are seeking to attend the REPRESENT! NCCPA Summit and how you believe it will impact your professional development, future practice, and mission as a PA. (Not to exceed 250 words.) It is recommended that you prepare your response in another application and paste your final response into this application.(Required.)
7.Please acknowledge that if selected you are available and have the support of your employer to attend the REPRESENT! NCCPA Summit to include arrival on Thursday, September 17 and departure after the last session on Saturday, September 19.(Required.)
8.Please acknowledge that if selected you will register for the REPRESENT! NCCPA Summit through NCCPA’s website or other means, as instructed.(Required.)
9.Please acknowledge that if selected you understand that you will be eligible for up to a three-night stay, including room and tax, at the Emory Conference Center and that any incidental hotel charges will be your responsibility.(Required.)
10.Please acknowledge that if selected you will book an economy class flight through the travel platform of recorded in accordance with instructions provided to you (or if local to the Atlanta area, seek mileage reimbursement).(Required.)
11.Please acknowledge that is selected you understand that you will be responsible for all associated costs beyond the hotel stay and airline ticket (or mileage reimbursement).(Required.)