2026 Advanced Education Scholarship Form

Advanced Education Scholarship
Ready to grow your career at ELMC² or the DCLS Symposium?

ASCLS-WA wants to help you get there. Our Advanced Education Scholarship covers registration for either the ASCLS Emerging Laboratory Managers Collaborative Conference (ELMC²) or the DCLS Symposium — two outstanding opportunities to sharpen your leadership skills and connect with peers shaping the future of laboratory medicine.

To qualify:
- Be a current ASCLS member
- Register for ELMC² or the DCLS Symposium
  
  Don't wait — register by October 9, 2026 to lock in the early bird rate and make the most of this opportunity. Your application covers your registration fees, since either session is virtual.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
ASCLS member number
If you would like to join ASCLS, please go to https://ascls.org/membership
Which Educational Program are you applying for?
Why are you interested in attending and what do you hope to get out of this conference. Please write a brief explanation addressing the above questions.
This scholarship is to cover expenses associated with one of the Advanced Education Programs. Please upload any documentation that shows your registration and expenses. We encourage early bird registration to get the best rate.

Browse Files

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Applicant's certification:

My sincere intention at this time is to attend the conference. In the event that I do not attend the conference, I understand that the scholarship will become a loan subject to repayment to the American Society for Clinical Laboratory Science-WA.
This application and documentation for a program must all be complete and received by November 1, 2026.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please send an email to Brenda Kochis when you have completed this form. Email is BrenKoch@comcast.net. This will ensure that we process your application as soon as possible.
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