( ) I am a program participant ( ) I am not a program participant
Please print this form and mail it to the address below. This form is not electronically transferable.
Name:
Address:
Institutional affiliation, if any:
Telephone:
Fax:
E-mail address:
1. Please check which of the following applies to you. I am:
___ a student (give name of institution)
___ a community historian
___ a member of an underrepresented group (e.g., racial-ethnic minority, gay or lesbian, working-class person, person with disabilities) Please identify: ________________________________
Please limit responses to 2 -3 paragraphs.
2. Please state your interest in oral history. Use this space or one additional page as needed.
3. Please explain your financial need. Be sure to include the amount of funding you are requesting. Use this space or one additional page as needed.
4. Please state the benefits to your community or group which will result from your attending the Oral History Association Annual Meeting. Use this space or one additional page as needed.
Total amount requested: $
(Requests cannot exceed $500)
I understand that funds may be used only for workshops, conference meals, and travel-related expenses (including hotel, meals, and transportation) and that the OHA will waive registration fees for successful applicants. I have not received an OHA scholarship in the past.
Signature_____________________________________Date____________________
Please return to:
Madelyn Campbell, Exec. Secretary
Oral History Association
Dickinson College
P.O. Box 1773
Carlisle , PA 17013
Application postmark deadline is July 14, 2006