2026 Cover AZ Training Scholarship Survey

Scholarship Application

The 2026 Cover AZ Training will be held on October 6 at Desert Willow Conference Center. This scholarship will cover registration fee, one hotel night stay (the night before). If awarded, please advise 72 hours before training date if you will not be able to attend. Failure to do so will result in personal liability to pay for missed hotel room rate. If awarded hotel night, awardee must confirm they will attend and provide a credit card on file in case of non-attendance, which will result in a personal payment. Deadline for submission is September 14, 2026. Please note that this scholarship is only for attendees residing outside of Maricopa County.

1.Mailing address(Required.)

First and Last name

Organization and Role/Title

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

2.What geographic area do you serve? (County and/or City)(Required.)

3.Please indicate whether you need a scholarship for registration, accommodations or both:(Required.)

Registration only

Accommodations/Hotel only

Both (registration and hotel)

4.Why should we award you a scholarship?(Required.)

5.If awarded, by submitting this form I will confirm I am attending and if unable to attend I will notify 72 hours before the training. If there is a no show, I will be responsible for payment, and I have confirmed the mailing address and contact information listed above is correct. (A credit card will need to be provided to the hotel as a placement hold.)(Required.)

I agree