Scholarship Request Form

Scholarship Request: CHA Region 1 2026 Canyonview Conference
Name*

First NameLast Name
E-mail Address*
Phone Number*

Area CodePhone Number
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you CHA Certified? Program: EWI, IRD, etc. *
Are you a CHA Member?*
What are your top three horsemanship goals?*
Why are you in need of a scholarship?*
What do you hope to gain from the CHA Region 1 Conference?*
How much of the $350 Conference fee can you pay?*
The silent auction funds our scholarship program. As a way of giving back, would you be able to donate anything to the silent auction?*
Should be Empty:

Scholarship Request: CHA Region 1 2026 Canyonview Conference