SCHOLARSHIP: Acceptance Form SCHOLARSHIPS: Acceptance Form This form is to be completed by the student. Questions can be directed to the Scholarship Committee Chair at scholarships@maatad5.org. Name * Name First Name First Name Last Name Last Name Current Institution: * Email: * Phone: * Name to be included on the Award Plaque: * Are you planning to attend the MAATA Conference? * Yes No Have you already registered for the MAATA Conference? * Yes No Do you plan to spend the night in Des Moines? * Yes No Would you like to be reimbursed for one night of hotel stay? * Yes No What entree would you like for the Awards Dinner? * Chicken Fish Pasta Student Signature * signature keyboard Clear Date * Submit If you are human, leave this field blank.
