Clone of 2024 Design Discovery Fund Application

IIDA Great Plains Chapter

Design Discovery Fund - Application Form
Name:

First NameMiddle NameLast Name
E-mail:
IIDA Member ID:
IIDA Member Category:
i.e. professional, associate, educator, student, industry
Employer:
Work Address :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Address :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:

Area CodePhone Number
Itinerary:
Estimated Budget:
(Include estimates of expected travel costs, registration fees, lodging expenses, meals and supplies. This should be as detailed as possible, with the understanding the budget can change, but will not exceed the $3500 fund max.)
Description of Additional Funding:
(Identify other means of support you are seeking, including employer reimbursement)
1. In 1000 words or less, describe the objective of the activity, its relationship to your current work / career goals and its relevance to the Great Plains Chapter.
0/1000
2. In 150 words or less, explain how receiving reimbursement would be meaningful for your professional growth?
0/150
5. How will you share what you have learned with IIDA Great Plains Chapter members? Be as specific as possible with your proposed activity.
0/500
6. Upload your single Letter of Reference from an employer, former teacher, or colleague in support of you and your activity here:

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100 MB limit Cancelof
7. Upload a current headshot for use by the chapter if selected:

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100 MB limit Cancelof
8. Upload any additional files for consideration:

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100 MB limit Cancelof
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:
Should be Empty:

IIDA Great Plains Chapter