NAIW Legacy Foundation Scholarship Application Submission Form

Only complete applications will be reviewed by the board of directors. All sections must be completed. STOP - Before continuing, be sure to have completed the scholarship application form in order to upload it to this submission form. Scholarship Application Form can be found here: https://www.internationalinsuranceprofessionals.org/resource/resmgr/legacyfoundation/2023_LegacyScholarshipAppli.docx

CONTACT INFORMATION

Name*

Mailing Address*

City*

State*

Zip*

Email*

Phone

Membership Information

Member Type*

Local Association Member

Member-At-Large

If Local Association, please specify

Region*

IAIP Join Date*

Industry Join Date*

SCHOLARSHIP INFORMATION

Scholarship Requested*

i.e. course title, conference name, etc.

Institution or Sponsoring Organization*

i.e. IAIP, industry organization, educational institution, etc.

Program/Event Date(s)*

Scholarships will only be awarded for programs/events occurring after the decision announcement date

Scholarship Amount Requested*

Amount awarded may be less than amount requested

APPLICATION SUBMISSION

Upload the scholarship application to complete your submission. Preferably, all documentation will be submitted in one attachment. If multiple attachments are required, up to 10 files can be attached to your application. Required Items:

- Scholarship Application

- Cost Documentation of Scholarship Requested

- One (1) Reference Letter

Attachments

Drag and drop files here or

Confirmation Email

If you would like to receive a confirmation email for your application, check the box below for "Send me a copy of my responses" to receive a copy of your submission.

Send me a copy of my responses

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