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 AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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 No 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)NameThis field is for validation purposes and should be left unchanged.