ARC Conference Scholarship Application Survey

We're glad that you are interested in attending SSTI's 2016 Annual Conference in Columbus, Ohio on November 1-3. Thanks to a partnership with the Appalachian Regional Commission, we are able to offer a limited number of scholarships to organizations located within and serving a portion of the ARC footprint, with priority given to organizations with financial need. Scholarships are for conference costs only, and travel costs remain the responsibility of the recipient.

To apply for a scholarship, simply complete this form by September 30. If you have any questions, contact Jason Rittenberg with SSTI at 614.901.1690 or at rittenberg@ssti.org.

1.Information for the applying organization.(Required.)

Organization

Address

Address 2

City/Town

State

ZIP Code

County

Website

2.Contact information for the primary scholarship applicant.(Required.)

Name

Title

Email Address

Phone Number

3.Contact information for a second applicant, if applicable.

Name

Title

Email Address

Phone Number

4.Briefly describe your organization's role in the regional innovation support network (e.g., support entrepreneurs, facilitate capital access, increase R&D or tech transfer, workforce, etc.).(Required.)

5.Explain why your organization needs a scholarship to attend SSTI's 2016 Annual Conference.(Required.)

6.If you receive a scholarship, can your organization afford to cover your travel costs?(Required.)

Yes

No

7.If you receive a scholarship, do you agree to participate in a post-conference debriefing to SSTI of the event's value for your work?(Required.)

Yes

No

By clicking the button below, you are submitting an application to receive an ARC-funded scholarship to SSTI's 2016 Annual Conference in Columbus, Ohio on November 1-3, 2016. The information you provide will be used by SSTI and SSTI alone to make scholarship determinations. All decisions are final. You certify that the information you have provided is truthful and accurate.