IMHF Scholarship Application

Award for Professional Development application

Application Submission Deadline is 90 days after completion of training/event
Review the scholarship policy before completing your application
Reviewed the policy? *

Yes
Eligibility you must meet all of the following to apply.

Worked at IMH for more than 1 year Are not planning to resign Finished training/event in last 90 days Paid for training/event personally No disciplinary action in last 12 months
Name: *

First Name Last Name
Email : *
Department: *
Date you where hired?

Month Day Year
Supervisors Email *
Have you applied for this Foundation scholarship before? *

Yes No
When did you apply last?

Month Day Year
Title of event/training: *
Information brochure or other description of what you did

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Completion date: *

Month Day Year
Final day of event or exam date
Receipt or other proof of payment

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Total expense with details: *
Summary of what was covered by event/training: *

0/300
Explain how this benefited you professionally? *

0/300
Explain how this benefited your department/Ivinson: *

0/300
Was this requested in your departments operational budget? *

Yes No
Why was it not requested?
By signing (typing your legal name) in the space below, you are agreeing to reimburse the IMH Foundation for any award received if you choose to terminate your employment within 90 days of receiving an award.
E-Signature: *
Should be Empty:

Award for Professional Development application