The Kelly Gartley Memorial Professional Development Scholarship Application

Kelly Gartley served as an officer and committee chair for COSA for many years and worked as the Community Services Coordinator for the City of Port St. Lucie. She was dedicated to collaborating and supporting the work of health and human service agencies in our community, as well as continuing education. Her energy and passion for making a difference were cut short unexpectedly in August of 2008. In honor of her memory and service, this annual professional development scholarship is awarded in her name.

This scholarship can be used for ANY professional development opportunity, including but not limited to costs associated with:

Continuing education credits
Attending a conference (registration, travel, lodging, or related)
Post-secondary education, such as a college or master’s degree level course
Completing a certification examination
Second language learning
Any others that contribute to your professional development!

Applicants must be a current and active member of the Council of Social Agencies.

If you are interested in being considered for this award, please complete the application below.

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

Office Phone

Please enter a valid phone number.

Cell Phone

Please enter a valid phone number.

Organization Name*

Your Position Title*

Hire Date*

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Office Phone

Please enter a valid phone number.

Cell Phone

Please enter a valid phone number.

High School:

Vocational training, if any:

Graduated

College (check appropriate box):

Major:

Minor:

Graduate School, if any:

MastersPh.D.Other

Area(s) of Study:

Additional information, if desired.

Program/Class/Seminar to be funded:*

Name of Hosting Entity:*

Indicate the goal of the training and how it will forward your professional development:*

Upload letters of reference, documents related to the request (e.g., conference details, credentialing, course details, etc.)

The Kelly Gartley Memorial Scholarship Application

Applicant

COSA Member Organization

Current Education

Health & Human Services Professional Development