NAEMSP DEI Annual Meeting Scholarship

Name *

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Last

Organization/Affiliation *

Email *

Address *

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Phone *

NAEMSP Membership Status (must elect one of these options to apply) *

What work are you doing at the intersection of DEI and EMS? *

How will attendance at the NAEMSP conference and pre-conference workshop impact your work? *

Workshop is on Monday, January 26th, 8:00 AM - 5:00 PM Empowering Leadership: Building Equity and Excellence into EMS Systems

Please briefly describe why you would otherwise not be able to attend this conference: *

Attach your CV (required) *

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Please attached your current CV in PDF format.