DIVERSE COMMUNITIES MEMBERSHIP DUES SCHOLARSHIP APPLICATION
Street Address Line 2
State / Province
Postal / Zip Code
CURRENT/MOST RECENT ORGANIZATION
CURRENT/MOST RECENT JOB TITLE
Organization Mission and Area of Focus
How do you describe yourself? (Race, ethnicity, disability,other)
Are you a current AFP member or have you been a member in the last three years?
Please describe in the space provided (one paragraph)your interest in receiving a scholarship and how an AFP membership will help you achieve your professional goals.
Should be Empty:
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