Conference Scholarships

WVRHA Conference Scholarship Application Form

November 15-17, 2023 Wheeling, WV

Thank you for your interest in attending the WVRHA Conference. Early application is recommended. Scholarship funds are limited, and applications will be evaluated based on the application below. Applicants who are awarded scholarship for full in-person attendance are expected to attend all three days of the conference unless they have extenuating circumstances.

Note: Attendees must agree to have their information shared with other speakers, attendees, and sponsors for networking within the conference platform.

Name *

First

Last

Title

College/University/Organization *

(If you are a student, please state your major and whether you are an undergraduate or a graduate student.)

Discipline (e.g. public health, nursing, health care administration, medicine, physician assistant, PT, OT, psychology, counseling, etc) *

Email *

Confirm Email

County of Residence *

Mailing Address (Please enter the address where pre-conference materials should be sent.) *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

State the reason you wish to attend the conference. *

(no more than 250 words total)

Explain how attendance will promote your practice in rural West Virginia. Give at least one example of how the conference agenda aligns with your goals as a health practitioner in West Virginia. *

(no more than 250 words total)

Are you a first time attendee? *

Conference Attendance Type: (check one) *

Full in-person attendance: no lodging
Full in-person attendance: lodging included, but may be shared

Are you willing to have your information shared with other speakers, attendees, and sponsors for networking within the conference platform? *