Staff Scholarship
Fiscal Year 2022-2023
Name:
First Name
Last Name
Library:
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
*
example@example.com
Name of training/event being applied for:
*
Date of training/event:
*
-
Month
-
Day
Year
Date
Type of Training:
*
Live Training
Virtual Training
Scholarship Amount requested:
*
Must not exceed $200
Work Phone:
-
Area Code
Phone Number
Library Position:
*
Director
Head Librarian
Please type your name in the box below to serve as your virtual signature.
*
Date submitting application:
-
Month
-
Day
Year
Date
Submit
Should be Empty: