ICPHSO Scholarship Program

ICPHSO Scholarship Program
The International Consumer Product Health and Safety Organization (ICPHSO) is proud to be the only organization that attracts a global audience of health and safety professionals who meet to exchange ideas and share information to address health and safety concerns. To do this effectively, ICPHSO needs to support stakeholders that may not have the resources to attend our meetings. ICPHSO provides the sole global forum for consumer product safety. Therefore, making sure that all stakeholders can participate regardless of their resources is an important goal that furthers the richness and breadth of our meetings.
APPLICANT INFORMATION
1. Organization Requesting Scholarship:*
2. Name of Person Requesting Scholarship:*
3. Current Position of Person Requesting Scholarship:*
4. Current Address:*
5. City, State:*
6. ZIP/Postal Code:*
7. Country:*
8. Email Address:*
WHY DO YOU FEEL IT'S IMPORTANT TO ATTEND THIS MEETING:
Please type your statement here (why do you feel it is important for you to attend the meeting(s). Include information that you will be able to share with the attendees and what you expect to learn from your experiences that could impact a positive safety change in your organization or community.*
GENERAL QUESTIONS
9. Do you have a Product Safety/Injury Prevention Program?*
10. Are you a member of ICPHSO?*

YesNo
11. If yes, how long?*
12. Have you funded yourself at any of the ICPHSO past meetings?*

YesNo
13. Will you be attending the entire event?*

YesNo
14. What will you be using the scholarship monies for?*

RegistrationAirfareHotelOther
15. Provide Estimated cost for airfare (if requesting airfare assistance) – Note – ICPHSO will only consider reimbursing lowest cost economy air fare requests in order to be able to assist the largest number of requester (s)*
19. Provide Total Amount of Scholarship Funds requested:*
20. Have you already received approval to attend this meeting?*

YesNo
21. When was the last time you attended an ICPHSO Annual Symposium?*
22. Other comments you may wish to make for consideration:
By inputting my name below, I hereby declare that the above information is correct to the best of my knowledge and authorize ICPHSO to use this information as my submission for scholarship.*
The costs covered by the scholarship will vary depending upon available resources and upon application requests. Not all requested costs may be covered. ICPHSO Executive Committee reviews and approves all requests. ICPHSO reimburse actual costs only and receipts are required for reimbursement. Reimbursement is provided after the workshop with submission of the reimbursement form and all receipts.
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ICPHSO Scholarship Program

APPLICANT INFORMATION

WHY DO YOU FEEL IT'S IMPORTANT TO ATTEND THIS MEETING:

GENERAL QUESTIONS