PNW Travel Grant Application

The IBDFrontiers team is proud to offer travel grants to advanced
providers and trainees, who are interested in attending our symposiums.
The travel grants are dedicated in the memory of Betty J White ARNP,
a leader in IBD education and practice in the Northwest who has inspired
and mentored numerous advanced practice provider trainees.
Betty has left a legacy showcasing a successful career after a passionate journey and was deeply appreciated by her patients, colleagues, and students alike.
Betty was a strong advocate in support of IBD education and our team has been proud to have collaborated with her in past educational venues

Saturday, March 7, 2026
7:00 am to 4:00 pm PST

Seattle Marriott Waterfront
2100 Alaskan Way Seattle, WA 98121
Grand Pacific Ballroom

Requirements for eligibility:
1. Event travel must exceed 50 miles
2. Completion of this form and Realease of Liabilty signature
3. Submit separate formal symposium registration
Please note- You can find the formal symposium registration link in your confirmation email.

Name*

First NameLast Name

Credentials

(e.g. RN, CNA, NP, PA, PA-C, Other, etc.)

Email*

example@example.com

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Current Position*

Employer*

Name of Supervisor*

Supervisor's Contact Number*

Program Director*

(For trainees only)

I have read the release of liability above and understand its contents, and by signing below indicate my agreement to all of its terms.*

Should you have any questions, please feel free to contact
Camille Fiene at cfiene@ibdfrontiers.org.