The CHIME Edge Scholarship Application Form

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Foundation Members:

The CHIME Edge Scholarship

Application Form

Submission due by
August 17, 2010.

I. Applicant Information (ALL fields required)

Candidate’s name:

Job Title:

Organization:

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

When did you join CHIME?
How long have you worked at your current
organization?
Have you attended one of CHIME’s education programs while at your current organization? Yes No
If so, which program and when?
What (and when) was the last educational program, other than CHIME, that you attended?
Please answer one of the following questions:

What is your organization’s bedsize?

OR

What is your organization’s annual revenue?

The following items must be included with your application form:

Scholarship Essay
Training/Travel Policy
Letter of recommendation

You will be required to submit the above documents on the next page.

Questions or comments? Send an email to membership@cio-chime.org.

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