WROCC@WOU
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Deadline: February 24, 2003
A limited number of stipends are available to cover a portion of the costs associated with the conference. If you are interested in applying for a stipend, complete the information below and submit a paragraph of not more than 250 words regarding your role and how the conference will be of benefit to you. Requests for stipends must be submitted by February 24, 2003. If you are chosen as a stipend recipient, you will be notified by e-mail by March 3, 2003.
Participant Information (Please print clearly.)
| Name: | |||
| Title: | |||
| SSN: | |||
| Organization: | |||
| Address: | |||
| City: | State: | Zip: | |
| Phone: | Voice | TTY | |
| Fax: | Email: | ||
| I am requesting a stipend to cover: | Registration Fees: | $ | |
| Hotel: | $ | ||
| Airfare/Travel: | $ | ||
Please understand that we may not be able to award a stipend to cover all expenses requested.
Don't forget to include a paragraph of not more than 250 words about your role and how the conference will be of benefit to you.
Mail or fax (503-838-8228) completed stipend request form to:
Regional Resource Center on Deafness
Western Oregon University
345 N. Monmouth Ave.
Monmouth OR 97361
ATTN: Cheryl Davis