Rural Scholarship Application
AEMS is pleased to announce Rural Scholarships available for the 13th Annual EMS Odyssey Conference on June 6-7, 2013 to be held at the Desert Willow Conference Center in Phoenix, Arizona. The scholarship application is located below and must be completed by an authorized representative of a Central Arizona Agency or Hospital on behalf of the nominee. NO self-nominations by individuals permitted. While applications must be received by May 4, scholarships will be awarded on first come, first served basis, with priority given to those agencies that are volunteer.
For more information, contact
Scholarship Terms of Agreement
*Scholarships will be awarded to individuals on behalf of their rural agencies/hospitals serving the Central Arizona Region (which includes Maricopa, Pinal, and Gila counties). In order for an individual to be eligible to attend the conference on scholarship, an agency/hospital must nominate him/her - NO self-nominations by an individual will be accepted. The individual nominated by the agency/hospital must dedicate his/her complete service to the needs of a rural community within the Central Arizona Region.
*There will be approximately 10 scholarships awarded to representatives of rural agencies/hospitals. A scholarship covers one registration fee to attend the 2013 EMS Odyssey Conference. The scholarship recipient is responsible for all other costs associated with traveling to and attending the conference including meals, hotel sleeping rooms, hotel incidental and amenity charges, mileage, etc.,.
*NOTE: No money (funding) will be exchanged with scholarship recipients or their agencies/hospitals - AEMS will coordinate the registrations of the scholarship recipients.
*Scholarships will be awarded on a first come, first served basis, with priority given to those agencies that are volunteer. All applications must be completed and returned via electronic filing by May 3. If you do not have access to the web, AEMS will, upon request, provide a hard copy of this application which you may return via fax or regular mail.
*All agencies/hospitals are eligible to receive one scholarship (more may be available pending response).
*An agency/hospital awarded a scholarship will be held accountable and responsible to ensure their nominee's participation in the conference - including, if necessary, finding a substitute. If a scholarship recipient does not attend and if no substitute is found, the agency/hospital will be required to reimburse AEMS for the conference fee. This stipulation is to ensure that an awarded scholarship is not squandered.
*AEMS reserves the right to request additional information about the scholarship nominee and his/herqualifications.
*All scholarship funding is pending and subject to funding received by the Arizona Department of Health Services.
Rural Agency - Hospital Representative Authorized to Complete this form
Rural Agency - Hospital Representative's Title
Rural Agency - Hospital Name
Rural Agency - Hospital Address
Scholarship Nominee's Name
Nominee's Title (ie EMT, Paramedic, RN, etc)
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