CASE VI Advancing Diversity Scholarship Application for 2012 Joint Conference Application Deadline is July 15, 2012

APPLY EARLY! -- Total of three applications per school allowed - first received, first reviewed basis.
Resumes are encouraged and can be e-mailed to lewisdi@umkc.edu.

** 75 word min for each question


Applicant Name *
Race/Ethnicity *
Professional Title *
Institution and Type. i.e. Independent, 2 year, public 4 year, private 4 year, other. And also the number of students enrolled this year. *
Work Address *
Work Phone *
Work Email *
Highest Level of Education *
Number of Years in Advancement Profession *
Area of Advancement Specialty *
Number of CASE Conferences Attended *
Number of CASE District 6 Conferences Attended *
What would you like to accomplish by attending this conference? *
Why did you choose a career in Educational Advancement? *
Sponsor's Name, Title, e-mail and Institution/Organization *
I confirm that this information is true and that all travel and accommodation costs, not covered by the scholarship, will be covered by my sponsoring institution or organization. I also acknowledge that I am interested in pursuing a career in educational advancement and identify myself as either Caucasian, American Indian/Alaska Native, Asian, Black/African American, Hispanic/Latino, Native Hawaiian/Pacific Islander, or Multi-racial. NOTE: Applicants residing in/near the host city of Chicago, IL are ineligible to receive the travel stipend. I also understand that I will have to provide a headshot and be listed in conference materials if selected.

Place a checkmark in the box to confirm the above is true. *