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* 1. First Name:

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* 2. Last Name:

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* 3. Your Title:

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* 4. Institution:

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* 5. Email Address:

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* 6. Cell Phone Number:

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* 7. Division:

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* 8. How many years have you been a collegiate coach:

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* 9. Describe your race/ethnicity:

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* 10. Has your institution paid IWLCA Annual Dues for 2023-24?

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* 11. Will your institution fund any professional development costs in 2023-24?

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* 12. Have you previously received an IWLCA Convention scholarship?

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* 13. Please indicate which years you have participated in the IWLCA Convention in the past:

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* 14. If you have never attended the IWLCA Convention before, please indicate why not:

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* 15. Please list the IWLCA or NCAA committees you have served on in the past (include the dates of service), and/or are currently involved with:

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* 16. Please use this space to tell the committee why you are deserving of this scholarship:

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* 17. If selected to receive a scholarship, will you commit to attending all scheduled sessions of the 2023 IWLCA Convention and Coaches Clinic?

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* 18. Please provide contact information for the Athletic Administrator at you institution who can verify that your institution will not pay for professional development (or will only partially pay) in 2023-24:

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* 19. If you would like to submit a statement of support from a colleague or administrator to accompany your application, please attach it here. This is not required to be eligible for a scholarship.

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