AzHIMA Professional Development Stipend

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Part I: The Nominee

The submission deadline date is April 16th.

1. About the Applicant

First Name *This question is required

Last Name *This question is required

Credentials

AHIMA Membership ID # *This question is required

Title

Organization

Street Address *This question is required

Apt/Suite/Office

City *This question is required

State *This question is required

Zip

Email Address *This question is required

Daytime Phone Number *This question is required

Evening Phone Number

2. # of Years in the HIM Field *This question is required

3. Essay: A 250-300 word essay on how this stipend would benefit your professional development.

Members of the AzHIMA Awards & Scholarship Committee will score this essay based on adherence to the topic, format compliance (must contain an introduction, body and conclusion), use of original ideas and/or concepts and coherence and completeness. The Awards & Scholarship Committee retains the right to publish the essay in the AzHIMA newsletter, Off The Record.

*This question is required