Conference Scholarship Application

Greetings! We are excited to award two scholarships (up to $500 each) to a national APCC conference of your choice (the AFCC annual conference, AFCC fall conference, or the AFCC-AAML biannual conference).

Name(Required)

First Last

Title(Required)

What is your occupation or role in your organization as it relates to AFCC?

Company / Organization Name(Required)

Work Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

AFCC Membership(Required)

How long have you been a member of AFCC (either the state chapter or the international organization)?

Board Member Experience(Required)

Are you a previous board member of AFCC Indiana?

Yes

Why are you interested in attending the conference?(Required)

How will attendance at the conference benefit those whom you serve?(Required)

Are there avenues through which you will share information from the conference with other professionals?(Required)

Phone

This field is for validation purposes and should be left unchanged.