HCIC@Home Scholarship Application


 

Which Category Best Describes Your Organization?*









 

Have you attended a previous HCIC conference?*

2010, 2012, etc.

Have you been involved with HCIC as a/an (Check ALL that apply):*




 

250 words or less

250 words or less

250 words or less
Several of our HCIC scholarship options are sponsored by vendors. Would you be willing to attend a 15-minute webinar demo with a vendor of interest to you in exchange for a scholarship to HCIC?*


 

Commitment to Attend
If selected to receive a scholarship to attend the 24th Annual HCIC, I hereby certify that I plan to attend. I understand that the scholarship entitles me to attend HCIC and one pre-conference workshop, but does not include my transportation and hotel costs or any other expenses related to my attendance. If selected as a scholarship recipient, I will provide HCIC (via email at jpense@healthcarestrategy.com, with a copy of my transportation and hotel confirmation within two weeks of notification of my acceptance.