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2013 DFW Business Travel Association
2013 Scholarship Application
Scholarship you are applying for: _________________________________________
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NAME: ____________________________
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TITLE: __________________________
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COMPANY:_______________________________
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PHONE: ______________________
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ADDRESS: ___________________________
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FAX: _______________________
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CITY, STATE, ZIP: ____________________
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E-MAIL: _________________________
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1. Position Level (check most appropriate)
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___ Coordinator
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___ Supervisor
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___ Manager
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___ Director
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__ Vice President or higher
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2. Responsibilities: Describe your responsibilities as they relate to staff supervision, budget, policy, negotiations and other areas (you may attach a separate sheet if needed).
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
3. Years in Industry _______
4. Years GBTA member _______
5. Years DFWBTA Chapter Member ______
6. Industry, GBTA and DFWBTA Activities (Officer, Committees, Speaker, Instructor, etc.)
7. Number of GBTA conferences attended _________
8. Accomplishments, Awards, Certifications and Publications
9. Continuing education, career goals and objectives:
Deadline for submission of all required materials is March 15, 2013 for Texas Education Scholarships. Partial applications will not be reviewed. This scholarship is only valid for registration and one night hotel stay. Please note that scholarship awards may not fully cover all expenses but will be paid for eligible receipts up to the scholarship amount. GBTA Conference Scholarship and CPC Leadership requires and endorsement from your company.
If you are a recipient of a scholarship will you commit to share your time and talents through involvement in DFWBTA by serving on a committee and/or supporting the chapter by your participation in meetings, events, and activities?
Yes: _____________ No: ______________
Affidavit: I certify that all information provided is true and if requested, proof of same will be submitted. Failure to provide documentation shall invalidate this application and result in termination of any aid granted.
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Scholarship Applicant Signature
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Date
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GBTA Conference Scholarship and CPC Leadership requires and endorsement from your company. Complete and send the attached signed form by the March 1, 2012 deadline.
COMPANY ENDORSEMENT OF APPLICANT
GBTA Annual Conference Scholarship
TO: DFWBTA Scholarship Committee
FROM: Name ____________________________________________________________
Title _____________________________________________________________
Company _________________________________________________________
Address __________________________________________________________
City, State, Zip _____________________________________________________
Phone _______________________________ Fax _________________________
E-Mail Address _____________________________________________________
SUBJECT: _______________________________________
Name of Scholarship Applicant
We are very pleased that _________________________________________________ is applying for a DFWBTA Industry Scholarship Grant. Please be assured that we will endorse and support this effort by confirming that we will provide the time for this applicant to attend courses/conferences selected necessary.
_______________________________________ ________________
Signature Date
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