SCHOLARSHIP APPLICATION

1. My BBB name

Address

Address Line 1

Address Line 2

City

State

Zip Code

2. I am applying for a scholarship for

Have you applied for the above checked conference with anyone else?

Yes
No

3. My CEO's First and Last Name

CEO's Email

CEO's Phone

4. Applicant's First and Last name and Title along with email and phone

Applicant's Email

Applicant's Phone

5. How many years have you worked at BBB?

6. Current Responsibilities

7. Please list any BBB positions you have held, including BBB, dates, titles and responsibilities

8. Please list any BBB or other management / professional development training you have received.

9. Should you be awarded a scholarship, will your BBB cover the costs of any additional expenses not covered by the scholarship?

YES
NO

10. Is your BBB current on its dues to IABBB

YES
NO

11. Would it be a financial hardship on your BBB if you attended the conference and a scholarship was not awarded?

Yes
No

12. In 300 words or less, please tell us why you are deserving of this scholarship, both from a professional and financial perspective.

will to your

13. Please provide an itemized budget including each item for which you are requesting assistance - in U.S. dollars. Please specify registration fee, airfare, hotel, how many nights, other relevant expenses and a TOTAL amount sought.

14. I understand, that if awarded a scholarship, I must submit a report to Carmen Million, Club President (cmillion@batonrouge.bbb.org) within 30 days of the conclusion of the training explaining the value and/or benefits received by participating. Upon receipt of my report, Ms. Million will release the funds to my BBB. Please sign below.

15. CEO signature below (if CEO is not the applicant) along with date