Scholarship

Email: *

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BARN Scholarship Application

Note: Incomplete applications will not be accepted

Recipients will be notified as soon as possible

Conference that you are applying for:

Do you consistently attend BARN meetings *

Yes

No

If so, what position?

How will you utilize the information that you learn to help BARN? *

Address *

ARN#

Broward Association of Rehabilitation Nurses

Have you participated on the BARN Conference Committee? *

Yes

No

Are you a current board member? *

Yes

No

Name: *

Are you a voting (tri-level) member? *

Yes

No

List years and positons:

In what Capacity?

Have you ever served on the board? *

Yes

No

Why do you want to attend the conference? *