2026_IPHA Annual Public Health Workforce Conference Scholarship Form

Apply for a Scholarship to Attend the Conference!

September 1, 2026 - September 3, 2026
IPHA may have limited funds to provide scholarships to cover registration and travel costs for students, community health workers, and other local public health professionals who might not otherwise be able to attend. Scholarship applications will be reviewed on a rolling basis until Monday, August 3, 2026, at 11:59 PM CST.

To be considered for the scholarship, please fill out the following information:
Name*

First NameLast Name
Email*
example@example.com
Job Title*
Company/Organization*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Estimated Travel Expenses

Fill out the information below.
Transportation
What type of transportation do you anticipate needing to travel to and from the conference?*
If you selected "Airfare", "Train", or "Rental Car", enter the estimated cost for that mode of transportation:
If you selected "Personal Vehicle", enter the estimated mileage reimbursement using your total number of travel miles and the current state mileage reimbursement rate listed below:
Current mileage reimbursement rate is 72.5 cents per mile
Hotel Accommodations
Check-In Date

MonthDayYear
Date
Check-Out Date

MonthDayYear
Date
Hotel rate per night (including taxes):
Total Anticipated Travel Expenses
Enter the total anticipated travel expenses from all the categories above:*
Upload any supporting documentation for your application. This can include letters of support, cost estimates for travel, etc.

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Enter any other information you feel may be useful for your scholarship application:
NOTE: Completing this form does not guarantee you will receive support to attend the conference. It is based on the availability of funds.

If selected for a scholarship, a member of the conference planning team will contact you.
Should be Empty:

Apply for a Scholarship to Attend the Conference!

Estimated Travel Expenses

Transportation

Hotel Accommodations

Total Anticipated Travel Expenses