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Wisconsin Rehabilitation Association Conference Scholarship Request Form


Each year, the Wisconsin Rehabilitation Association (WRA) will offer up to 4 $500.00 scholarships to attend the annual WRA state conference, usually held in April. These scholarships are intended for students, consumers and other individuals in the rehabilitation field with financial need. Interested applicants are asked to complete the information below, and send to:

Michael Hermsmeier, WRA President
416 W. Oak st
Cottage Grove, Wi. 53527

Applications for the WRA spring conference are due by February 19th.

   
Date:
Name:
Address:
Address:
(Line 2)
City:
State:
Zip:
 Phone:
 Email:
Reasons for requesting scholarship:
(Please describe your current status, i.e. student, consumer, other, financial need, and interest in becoming involved with WRA)
**If more space is needed, please attach another sheet of paper
References:
(Please list 2-3 references, with address and phone)
*If more space is needed, please attach another sheet of paper

 WRA Conference Scholarship Form   Download Form
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