grants

Play Make Learn Scholarship Request

Play Make Learn Scholarship Request Form

First name *

Last name *

E-mail Address *

Library *

Scholarship purpose (choose one) *

Full Conference (up to $350)

Lodging and Travel Only

Registration Only

Amount requested * $

Up to $350

Entity paying *

you

your library

your library's Friends group

other: please provide details

Entity paying other: please provide details

The entity which pays the expense is to whom the reimbursement check will be made payable.

Please describe how you, your library, and your community will benefit from your attendance at this conference (up to 500 words) *

A paragraph or two about how this activity will help you provide excellent service to your community, and how the scholarship will help your library.

First time attending this conference? *

yes

Activity start date *

Month

Day

Year

Activity end date *

Month

Day

Year

Leave this field blank

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