Scholarship Application

Please take a moment to complete the Scholarship Application form. All fields are required except those followed by (NR).

 

Participant Information

Name:
Title:
Agency/Organization:
Department/Division:
Address:
City:
State:	Zip:
Phone: (enter as: XXX-XXX-XXXX)
Fax: (enter as: XXX-XXX-XXXX)	(NR)
E-mail:

 

Additional Information:

Total Number of Employees in Agency/Organization:

Total number of employees in your Department/Division:

Please list the Cascade Executive Programs course(s), location(s) and date(s) for which you are requesting tuition assistance:

Please describe your financial need (please be as specific as possible):

How much is your agency/organization able to provide from internal sources:

Please describe how this course would help you in your job performance:

Please check the box of any professional associations you belong to: Seattle Management Association Washington City/County Management Association Washington City Planning Directors Association Washington Finance Officers Association Washington Public Ports Association Washington State Association of County and Regional Planning Directors Other:

Additional information or comments that might be helpful for the review committee:  (NR)

 

 

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