IDA Conference Scholarship Application

Date*

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

I am:*

an IDA member (please provide member number below)
not an IDA member

IDA Member Number

Have you attended an IDA Austin conference in the past?*

Yes
No

My interest is as a(n):*

Parent (please provide the name of your child's school, district, and grade in the box below)
Teacher (please provide the name of your school, district, and current teaching position in the box below)
Therapist (please provide your current title, certification, and training program in the box below)
Student (please provide the name of your school and area of study in the box provided below)
Individual with dyslexia (please provide your current occupation in the box below. If you are currently unemployed, please indicate "unemployed.")

Please provide additional information here.

References*

Please provide the names and email addresses of two personal or professional references. One should be connected to your employment, training program, child’s school, or your school.

Statement of Interest*

Please provide a statement of interest, 300-500 words, which includes at least three reasons why you should be considered for this scholarship, as well as how you plan to share what you will learn with your colleagues/peers. Use the Choose File button below if you prefer to attach your statement separately.

2023 IDA Austin Conference Scholarship Application