Scholarship Application Form

for NWRA Symposium attendance

Deadline: October 1

Scholarship(s) applying for (check all that apply):

James J. Wolf CARE for Wildlife Education Scholarship (500 US Dollars)

Debra L. Chandler Memorial Scholarship (500 US Dollars)

Eric Sticht Memorial Scholarship (600 US Dollars)

*Alma Natura Trust Scholarship-North American Region (750 US Dollars)

*NOTE: Applicants for this scholarship may reside in Canada, the United States or Mexico; candidates outside North America, please use the Alma Natura Trust International Scholarship Application Form.

A symposium attendance scholarship recipient is expected to attend at least three (3) full days of the symposium. NWRA reserves the right to withhold scholarship fund disbursement if attendance requirement is not fulfilled.

Contact Information:

Name: / Phone #:
Address:
City: / State: / Zip/Postal Code:
Country: / Fax #: / Email:

Rehabilitation Information

Experience as a wildlife rehabilitator (# of years):
Licensure (if applicable):

List rehabilitation affiliations:

Have you attended other wildlife conferences? YesNo If yes, which conferences?

Have you helped put on a wildlife conference? YesNo

If so, what did you do (planning, speaking, hosting, volunteering)?

Because these scholarships are partially based on financial need, please briefly describe any pertinent factors that may affect the committee's decision in awarding the scholarship (in 50 words or less):

Briefly describe how you would benefit from attending this symposium:

What are your expectations from the symposium?

The information contained within this application is true to the best of my knowledge. I understand that misrepresentation or fraudulent information may be grounds for loss of scholarship funds. I understand that, in accepting a scholarship from the National Wildlife Rehabilitators Association, I give permission to announce my receipt of a scholarship to the scholarship donors and to the NWRA board of directors and members. I further give permission to list my name as a scholarship recipient in the NWRA newsletter, the NWRA annual report, and on the NWRA website(s). All personal information related to financial need or status is not shared and is kept confidential. I understand that I may be asked to write a letter of thanks to a scholarship donor and/or to NWRA and that the letter to NWRA may be published in part or in its entirety in NWRA materials. I understand that I am requested to write a paragraph or two summarizing how this scholarship has affected my rehabilitation, and that it may be published in part or in its entirety in NWRA materials.

Signature: / Date:
If emailing application: By checking this box, I understand and agree to the above statements.

Scholarship Application Form Instructions:

Please enclose two (2) signed letters of recommendation with the scholarship application form.

The Word document may be downloaded and/or printed to be filled out by hand. Additionally, the Word document may be saved to your desktop, filled in electronically, and attached to an email sent to the NWRA address. In addition, applicants can use the online forms available on the NWRA website.

If mailing or faxing the application form and/or signed letters of recommendation:

1.Type or print all application information requested in English.

2.If you are unable to write or type information onto the form, please contact the NWRA Central Office through the contact information below.

  1. If you need assistance or have questions regarding the scholarship application process, please call (320) 230-9920 or email: ,

Subject line: Scholarship

  1. Send completed and signed application with two (2) signed letters of recommendation to:

NWRA Office

c/o Scholarship Committee

2625 Clearwater Road, Suite 110

St. Cloud, MN 56301

Fax form to: 320-230-3077

  1. If sending signed recommendation letters separately through the Postal Service, please include the name of the scholarship applicant with each letter sent to the above address.

If emailingthe application form and/or signed letters of recommendation:

1.Before filling out, download and save the Scholarship Application form (.doc version) onto your computer.

2.Completely fill out the Scholarship Application form electronically directly within the Word document. Type the application in English.

  1. If you need assistance or have questions regarding the scholarship application process, please call (320) 230-9920 or email: ,

Subject line: Scholarship

  1. Control + Click on the NWRA link below brings up a pre-addressed email; attach the completed application with two (2) signed letters of recommendation (.pdf or .doc format ONLY). ,

Subject line: Scholarship Application

  1. If emailing signed recommendation letters separately, please include the name of the scholarship applicant with each letter and send in .pdf or .docformat to: ,

Subject line: Scholarship Application