Kansas Blood Services Application
Kansas Blood Services Fund with the Topeka Community Foundation provides continuing education scholarships for individuals in the medical field of blood banking or a related field. Scholarship is available to professionals in the following counties: Shawnee, Douglas, Lyon, Jackson, Jefferson, Nemaha, Osage, Pottawatomie, Riley and Wabaunsee.
Name
*
Employer
*
Employer's Address (Street, City, & Zip Code)
*
Email address
*
example@example.com
Daytime Telephone
*
Position
*
Class/meeting you wish to attend
*
Date and location of class/meeting
*
/
Month
/
Day
Year
Date
Deadline for registration
*
Statement describing your career in blood banking or related field.
*
Statement describing your career goals and how attendance at the professional meeting will enhance your career.
*
Letter of recommendation from your immediate supervisor.
*
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Breakdown of conference expenses requested to be covered by the scholarship
*
If you have questions please contact Marsha Pope, pope@topekacommunityfoundation.org
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