WSHMMA event scholarship

Member Questions

Thank you for your interesting in an event scholarship to attend the WSHMMA annual educational and networking event.

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* 1. Type of Scholarship you are applying for:

Event registration to be covered only

2 night stay in a hotel only

Full Scholarship [2 nights stay at the host hotel and event registration]

What City will you be traveling from:

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* 2. Are you a involved in a supply chain function of healthcare facilities, or are active in the healthcare materials supply chain, including manufacturers, vendors, distributors and group purchasing organizations?

Yes

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* 3. Are you employed by:

Acute Care Facility [hospital or IDN]

Non-Acute Facility [ASC or clinic or veterinary]

Vendor [mfg or distributor]

GPO

Other (please specify)

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* 4. Do you work or reside in the WSHMMA states [WA, OR, ID, MT, AK]?

Yes

If no, please specify

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* 5. Personnel Info:

Name

Company

Work Address

Work Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 6. Are you a current member of WSHMMA?

Yes

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* 7. Are you a first-time Conference attendee?

Yes

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* 8. Do you belong to any other AHRMM chapters?

Yes

if yes, please let us know which one(s):

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* 9. Are you a current member of AHRMM?

Yes

Please list your AHRMM member number:

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* 10. Do you have any AHRMM certifications?

CMRP

FAHRMM

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* 11. Are you on any AHRMM committees?

Annual Conference Education

Chapter Relations

Education

Fellow Review

Issues and Legislative

Membership

Nominating

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* 12. Why do you require financial assistance to attend the annual conference? (Attach a letter from your manager or supervisor that establishes financial need or if you are between jobs, provide an explanation of financial need.)