Application for Advanced (formerly Specialist) Training Scholarship
Please provide the following information:
Name
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First Name
Last Name
E-mail
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Phone
*
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Area Code
Phone Number
Type of advanced training
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Date of advanced training
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Month
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Day
Year
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Location of advanced training
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I agree that:
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If approved, I will receive the scholarship in advance to defray training costs. I agree that the scholarship will be repaid to DCMGA if the I fail to complete all state training and volunteer requirements for certification, as well as the 2-hour DCMGA help desk commitment.
Submit Application
Status of application:
Approved
Disapproved
Date of approval/disapproval:
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Month
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Day
Year
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Date check issued:
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Month
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Day
Year
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Date advanced training and volunteer requirements completed:
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Month
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Day
Year
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Date help desk requirement completed:
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Month
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Day
Year
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Additional comments:
Should be Empty: