AHRMM22 UDI Forum Scholarship Application Survey

AHRMM is pleased to offer financial assistance for qualifying members to attend the UDI Forum, powered by the AHRMM LUC, November 1-3, 2022.

Registration Scholarship – The scholarship covers full registration to the UDI Forum.

To qualify, you must meet the requirements listed here and complete this application. Applications are due on October 14, 2022. All applicants will be notified of results by October 21, 2022.

To apply for the scholarship:
1. Complete the online application.
2. Submit a letter from your CEO or supervisor that establishes financial with application. If you are between jobs, only the application is required.

To become an AHRMM member, visit www.ahrmm.org/join or call us at 312-422-3840.

Contact Information(Required.)

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

AHRMM Membership Number(Required.)

Are you a new member?

Yes

No

Have you attended and AHRMM Conference & Exhibition in the past?

Yes

No

Are you an AHRMM chapter member?

Yes

No

Chapter name (if applicable):

Do you have your CMRP designation?

Yes

No

Are you an AHRMM Fellow?

Yes

No

Why do you require financial assistance to attend the AHRMM UDI Forum?

What do you want to gain from attending the AHRMM UDI Forum?

How will you share what you learn at the AHRMM UDI Forum with your colleagues?

A support letter from your CEO or supervisor that establishes financial need can be uploaded here or emailed to ahrmm@aha.org after your application submission. Please include your name and member ID.

No file chosen