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2024 Scholarship Application Form
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* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Are you an AHG Member?
*
Yes
No
What type of scholarship are you applying for? (choose no more than one)
*
Symposium Scholarship
Webinar Scholarship
Membership Dues
Complimentary issues of JAHG
If applying for Symposium scholarship: Are you interested in- the in-person Symposium (Black Mountain, NC) or the online scholarship option?
In-person
Online
Not Applicable
Clear selection
If applying for a Symposium scholarship, are you applying for a full or partial scholarship?
Full Scholarship
Partial Scholarship
Not applicable
Clear selection
Reason for applying:
*
BIPOC
LGBTQIA+
Individuals with Disabilites
Elderly Individuals on Fixed Income
Financial Need
Other
Is there anything else you'd like to share about your scholarship request?
Your answer
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