CLSI Scholarship Application 2019 Question Title * 1. Please indicate how you qualify for the CLSI. (Select more than one if applicable). I am a promising and committed cooperative employee and/or board member, aged 18-35. I am a post-secondary student recognized for my demonstrated interest in cooperatives and credit unions. OK Question Title * 2. Please list the cooperatives and/or cooperative organizations with which you have been affiliated and your role(s). OK Question Title * 3. Describe your interest in cooperatives and what you hope to get from the Cooperative Leaders and Scholars Institute. Please do so in 300 words or fewer. OK Question Title * 4. Please give us the name of your recommender. OK Question Title * 5. Please give us the title of your recommender. OK Question Title * 6. Please give us the email address of your recommender. OK Question Title * 7. Please upload your recommendation. Word or PDF format please. PDF, DOCX, DOC file types only. Choose File Choose File No file chosen Remove File Please upload your recommendation. Word or PDF format please. OK Question Title * 8. Do you have any dietary restrictions we should be aware of? OK Question Title * 9. Do you consent for NCBA CLUSA and CDF to use images of you, video recordings, etc. taken while you attend the CLSI? These will be used in CLSI and IMPACT Conference related materials, published on our websites, publications, etc. Yes No OK Question Title * 10. Please provide your name, contact information and - if you'd like - preferred pronouns. OK DONE