Memorial Scholarship Application

If you or someone you know can benefit from a tuition scholarship to the Wyoming Writers’ annual conference, please print this form, fill it out, and send it to Nancy Wall, 2769 Jerome Street, Pocatello ID 83201. Please print, type, or write legibly. Photocopies are acceptable. If more space is needed, use a separate sheet of paper. Deadline for applications is the last Friday in April prior to the conference.

Questions may be sent to scholarship@wyowriters.org

Name of Writer:		WWI Member?
Address:
City:	State:	ZIP:
Phone Number:	Marital Status:	No. of Children:

State in your own words why you believe the nominee should be considered for a scholarship:

List any unusual circumstances (i.e., illness, financial burden, etc.):

What type of writing does the nominee do?

Has the nominee been published?

If yes, list publications:

Please list any other information that the scholarship committee should consider:

This application submitted by:

Address:
City:		State:		ZIP:

Committee Use Only:

___ Applicant Approved

___ Applicant Not Approved

___ Applicant Alternate

Wyoming Writers, Inc.