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KAIMH Conference 2022 Scholarship Application
Please complete this form to be considered for a full scholarship to attend the KAIMH 2022 Conference. Once the committee reviews your application we will notify you of next steps. For questions regarding the status please email
info@kaimh.org
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Email
*
Your email
Name
*
Your answer
Address
*
Your answer
Email Address
*
Your answer
Agency Name
*
Your answer
Job Title
*
Your answer
Race
Your answer
Ethnicity
Hispanic
Non-Hispanic
Are you a member of KAIMH
*
Yes
No
Required
Have your earned or are you working on the KAIMH IMH Endorsement?
*
Yes I am Endorsed
Yes I am working on my Endorsement
No I am not Endorsed
No but I am Interested
Send me a copy of my responses.
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