WAHMR
P.O. Box 46076
Madison, WI 53744+6076
   

Scholarship Application

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Fill out the following completely as possible. Scholarships are available to WAHMR members. Scholarships may be used for class work, convention attendance, and tuition. We like to see you be able to "pass-it-forward" and share the information gained with others. Applications will be discussed by the Board of Directors at their Quarterly meetings.

Please provide the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Please describe the Training you are interested in attending. Please be detailed. Include webpage information of the training if possible.

How will this help you and your agency/department? How will you share the information gained with others?