Scholarship Application “ ”

Founded in Memory of Samuel T. Orton
Scholarship Application
October 2014
“RAVE-O Training”
The Iowa Branch of IDA is offering a limited number of scholarships to individuals in education or
another related field. The scholarship will be applied to the training registration fee only.
Recipient will be required to register for training immediately upon notification of the scholarship
award. The training date is: October 17-18, 2014. See deadlines below.
Name__________________________________________________Date______________
Type of Teacher/ Educator ________________________________________________
Home Address ____________________________________________________________
City/State/Zip ____________________________________________________________
Home Phone Number ______________________ Work Number ________________
Email Address ____________________________________________________________
School/District/Home School Affiliation ____________________________________
Name of Educational Institution __________________________________________
Are you a current IDA member? _____Yes
______No
Have you applied for any other financial assistance to attend this training?
______Yes ______ No If yes, where ____________________________
Have you previously received a scholarship from the Iowa Branch of IDA?____
Please tell us briefly why you are interested in attending our training and how it
will help you.
Please email or mail this application by September 22, 2014 to:
Scholarship Application for Teachers
International Dyslexia Association – Iowa Branch
PO Box, 11188, Cedar Rapids, IA 52410-1188
E-mail: iowabranchdys@yahoo.com
The committee will notify you by 9/29/14 and training registration must be postmarked
by 10/13/14.
P.O. Box 11188  Cedar Rapids, IA 52410-1188