SCHOLARSHIP APPLICATION 37th Annual WAAODA Conference May 12, 13, and 14, 2003 in Madison, Wisconsin


Scholarship covers full registration – $350. Hotel lodging is not included (single :$62/night and double :$72)

Eligibility: All Wisconsin residents may apply.

Requirements: All applicants must supply the information requested below.

Selection: Scholarships are awarded, by a committee, on the basis of financial need, geographic region, and length of employment in the AODA field.

Deadline: Applications are due to the WAAODA office by March 25, 2003.

Notification: Scholarship recipients will be notified by April 15, 2003.

Name:_______________________________________________________ (PRINT)

[] Male [] Female

Address:__________________________________________________________________

City:__________________________________ State: WI Zip:___________________

Day phone:____________________________ Evening phone:________________________

Did you receive a scholarship in 2002? []Yes []No 2001? []Yes []No 

What is your current employment status?
[] Student  [] Part-time in AODA field [] Full-time in AODA field

What is your annual income?
[] Under $15,000 [] $15,000-$30,000 [] Over $30,000

Does your employer reimburse you for training expenses? Explain:__________________________________________________________________________________________

Length of work experience in AODA field:
[] 6 months-year [] 1-3 years [] 3-5 years [] Over 5 years.

Please mail or Fax this application to the WAAODA office by March 25, 2003.
6441 Enterprise Lane-Suite 105, Madison, WI 53719 Fax: 608-276-3402.
Phone 800-787-9979. You will be notified by April 15.


For more information:
WAAODA
6441 Enterprise Lane — Suite 105
Madison, WI 53719-1180 US
Email: [email protected]
(608) 276-3400
Fax: (608) 276-3402

© Copyright 2003 Wisconsin Association on Alcohol and Other Drug Abuse, Inc.. All Rights Reserved.