WAMCAT Scholarship Application

* Name

* Title/Position

* Email address

* Length of Service in Position

* Phone Number

* Municipality

Mailing Address

* Current and Active WAMCAT Member?

Yes
No

Payment Date of Most Recent Membership Dues

Applicant must have attended at least one (1) WAMCAT workshop or annual meeting within the past year. Please list the workshop(s) you have attended that meet this requirement:

Have you previously applied for scholarship funding?

Yes
No

If Yes, when?

Was prior funding request approved?

Yes
No

If Yes, amount of funding $

Have you held, or do you currently hold, a WAMCAT office or served on the Board or on a WAMCAT Committee?

Yes
No

If so, please list date(s) of service:

Purpose of Funding Request Information

WAMCAT Institute

Institute Name:

Site:

Proposed Attendance Dates:

WAM Conference

Training/Education Session:

Site:

Proposed Attendance Dates:

National Institute of Municipal Clerks (IIMC) Certified Municipal Clerk (CMC) Program

Training/Education Session:

Site:

Proposed Attendance Dates:

National Association of Public Treasurers of the United States and Canada (APTUS&C) Certified Public Finance Administrator Program

Training/Education Session:

Site:

Proposed Attendance Dates:

College Course, Continuing Education and Correspondence Course

Training/Education Session:

Site:

Proposed Attendance Dates:

Explain your initial certification / education training plans and how scholarship funding will assist you (attach additional sheets or information if needed)

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WAMCAT ID:

Password:

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