2023 Leadership & Advocacy Travel Scholarship

Application

This scholarship award will cover up to $500 in housing and transportation costs. This may also include your registration fees, but it may NOT cover food/beverage charges as all meals are provided at the conference.

If you have any questions, please do not hesitate to contact D’Arcey Johnson, at djohnson@facs.org.

Application deadline: Friday, February 3

Question Title

* 1. Full Name

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* 2. Contact Information

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 3. Institution Information

Institution

Year of residency

Specialty, if known

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* 4. Dates you plan to attend (include travel dates)

Saturday, April 15

Sunday, April 16

Monday, April 17

Tuesday, April 18

Wednesday, April 19

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* 5. Please upload a brief summary (no longer than one page) explaining why this opportunity interests you, what you hope to gain from it, and how you plan to utilize the knowledge you obtain.

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2023 Leadership & Advocacy Travel Scholarship

Application

Question Title

* 1. Full Name

Question Title

* 2. Contact Information

Question Title

* 3. Institution Information

Question Title

* 4. Dates you plan to attend (include travel dates)

Question Title

* 5. Please upload a brief summary (no longer than one page) explaining why this opportunity interests you, what you hope to gain from it, and how you plan to utilize the knowledge you obtain.

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* 6. Have you attended the Leadership & Advocacy Summit before, either virtually or in-person?

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* 7. Have you received a Leadership & Advocacy Summit travel scholarship previously?

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* 8. Are you a U.S. Resident member in good standing with ACS?