CHILIS Scholarship Application

CHILIS awards scholarships to CHILIS members to enable them to engage in professional development activities. Scholarships can be used to defray/cover the costs of the following: library conferences, module courses offered by the State Library, and other continuing education offerings.

Name _________________________________Library______________________________

E-mail _________________________________________ Phone __________________

Address _________________________________________________

Are you a member of CHILIS? Yes No

In what way does your library financially support staff development/continuing education?

__________________________________________________________________

Conference/Course Title (ie. Activity to be Funded) ______________________________

Location ___________________________________

Date (s) ____________________ Program/Course Fee (s)______________

Other expenses for which you are seeking scholarship aid: Course Materials_______

Mileage (current federal rate) _____ Overnight Expenses______

Meals (not included with event) _________

Total Scholarship Request $______________

Are you able to pay up front and wait for reimbursement? Yes No

Briefly state what professional goals will be met by attending the conference/course:

_______________________________________________________________________

_______________________________________________________________________

Briefly explain why you are applying for the scholarship:

______________________________________________________________________

______________________________________________________________________

Applicant's Signature _____________________________________________

Please send application to:

Ann Hoey, NH State Library, 20 Park Street, Concord, NH 03301 (van route: Concord, NHSL)

Please Note: Scholarship applications will be reviewed at monthly CHILIS Board meetings, and recipients will be contacted within a week of the meeting.