USI Affinity

Institution Information TIP:

Alumni Association
Office of Alumni Relations/Affairs
University Department
Other

Applicant Information

Numbers only, no dashes.

Professional Development Information

What type of professional development activity are you applying for? TIP: When will it occur? TIP:

Estimated Expenses (registration, supplies, travel, etc.) TIP:

No commas, please

NOTE: Complete either the Individual or Group section below.

Individual Scholarship

Have you been awarded a NEAT Professional Development Scholarship in the past?
Yes
No
If Yes, in which year(s)? Note: Do you have direct involvement with alumni relations?
Yes
No
Length of Time in Institutional Advancement:

Length of Time in Current Position:

Please answer the following question.
Note: It may be helpful to save your text in a separate document and paste it into the form field when you are ready to submit.

Group Scholarship

Is this opportunity directly related to alumni relations activities?
Yes
No

Please answer the following question.
Note: It may be helpful to save your text in a separate document and paste it into the form field when you are ready to submit.

Acknowledgements

If selected to receive a Professional Development Scholarship:

I agree to submit a brief summary or testimonial following my/our participation. The NEAT has my permission to use this information to promote the program and/or include on the NEAT website. Photos are also appreciated!

I will submit an invoice with receipts to show expenses incurred for reimbursement

Checks can be made payable to the institution or individual depending on how activity was originally funded.

Acknowledgement to be completed by supervisor:
I support this application and will fund the balance of the expenses for professional development if the applicant is chosen for a NEAT Scholarship.

Scholarship Application