Florida ACRL Fall Program

Student Scholarship Application Form 2011

Name:

E-mail:

Phone number:

Address:

Library School (Or equivalent. We may contact the school to confirm enrollment.)

School:

Contact name at the School:

School Address:

Website:

By submitting this application I understand that, if I am chosen and accept a scholarship award, I am required to attend the FACRL 2011 Fall Program (at the Embry-Riddle Aeronautical University, ICI Center, Daytona Beach, FL 32114, on Friday, October 21, 2011) and to participate as a panelist on a panel organized by the FACRL Board. I understand that if I do not attend the program and participate in the panel I will be asked to reimburse the full scholarship amount to FACRL. By submitting this application I confirm that I have read this statement and attest to the truth of all information submitted in my application and consent to the above requirements.

Signature: