Cincinnati AEYC


Full Name:
Phone:
Email:
Date:
Organization:
Position:
Student Status:	Yes No
Institution:
Degree Plan:
CAEYC Member:	Yes No
Preference:	Pre-Conference Regular Conference
Reason for Wanting to Attend:
Enhance:

Scholarship Application
for the 4C Leadership Conference: "Leading the Way to Quality through Building Relationships"

Two (2) Pre-conference scholarships available for the evening of October 6.
Five (5) Scholarships are available for the day sessions on October 7.


Full Name:
Phone:
Email:
Date:
Organization:
Position:
Student Status:	Yes No
Institution:
Degree Plan:
CAEYC Member:	Yes No
Preference:	Pre-Conference Regular Conference
Please provide your reason for wanting to attend the 4C Leadership Conference (~1 paragraph)
Please state how you anticipate your attendance at the 4C Leadership Conference may enhance your work or education (~1 paragraph)

You will be required to submit to the board of CAEYC a brief summary of your experience at the 4C Leadership Conference that may be reproduced for our membership on the CAEYC website/or newsletter

Selection Process: If more than 7 registrations are submitted we will take those applicants who have completed all information correctly and place their names in a hat and draw the winners. If selected we will ask that you fill out the attached consent form.

Thank you for you interest and participation. We are excited about receiving your scholarship application.

Must be submitted by September 16, 2005 to be considered.

Scholarship Application for the 4C Leadership Conference: "Leading the Way to Quality through Building Relationships"

Scholarship Application
for the 4C Leadership Conference: "Leading the Way to Quality through Building Relationships"