Play Make Learn Scholarship Request Play Make Learn Scholarship Request Form First name * Last name * E-mail Address * Library * - Select -BerlinBrandonCampbellsportColomaEndeavorFond du LacGreen Lake (Caestecker)HancockKingstonMarkesanMenashaMontelloNeenahNeshkoroNorth Fond du Lac (Spillman)OakfieldOmro (Carter Memorial)OshkoshOxfordPackwaukeePine River (Leon-Saxeville)PlainfieldPoy SippiPrincetonRedgraniteRiponWautomaWCTSWestfield (Ethel Everhard Memorial)Wild Rose (Patterson Memorial)WinneconneWinnefox 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. Anything else you'd like to share? First time attending this conference? * yes no Activity start date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202320242025 Activity end date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202320242025 Leave this field blank CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Read more about Play Make Learn Scholarship Request
