Student Career Development and Leadership Awards Application

*** Please note that funding could affect any financial aid package that you may currently have. If you have any concerns about this, please contact the financial aid office at 217-333-0100 ***

Program: (check only one)

• Community Health
• Kinesiology
• Recreation, Sport and Tourism
• Speech and Hearing Sciences

Applying for: (check only one, submit separate forms for each)

• Professional Organizations-student membership fees ($50-75.00 per membership)
• Conference Travel ($250.00 to assist with travel-related expenses for student presenting at conferences)
• Study Abroad ($500.00 to assist with travel-related expenses)
• Leadershape (please see your academic advisor for details)

I am requesting the following amount to assist with the following expenses (please indicate the organization and membership, conference name and location, date of use, or study abroad school and location you are seeking: *Please note, the award must be used in the semester you are applying, (Spring awards may, however, also be used in the summer term.)
$

Are you receiving any additional funding from another source for this request?

• Yes (if yes, please indicate the source of additional funding)
  
• No

Please provide a personal statement describing your interest and need for the award. Additionally, please submit a current resume in addition to this application. Applications and resumes can be dropped off in 220 Huff Hall or emailed as an attachment to Kathy Runck. Applications are not complete until we receive a resume.

Please enter your full name here:

I am acknowledging that this is my electronic signature which I am signing and submitting through this electronic form by checking this button.
Signature acknowledgement.
(This form will not be accepted without your signature acknowledgement.)