The Mary Fran Myers Scholarship
2015 Application Form

Use this application form to apply for the Mary Fran Myers Scholarship to attend the Natural Hazards Research and Applications Workshop in Broomfield, Colorado, July 19-22, 2015.

Please answer all questions. Incomplete or late applications will not be considered. For the 2015 competition, applicants must reside outside of North America or the Caribbean. Eligibility is based on current place of residence, not citizenship. Applicants in North America and the Caribbean will be eligible for the scholarship in 2016.


First Name 
Last Name 
Affiliation 
Address 
 
 
 
City 
State or province 
Zip Code 
Country 
Phone 
E-mail Address 

Have you previously attended the Hazards Workshop?

 Yes
 No

References: List three persons familiar with your qualifications.

Name 
Position 
Organization 
Phone 
E-mail Address 
Name 
Position 
Organization 
Phone 
E-mail Address 
Name 
Position 
Organization 
Phone 
E-mail Address 

Employment Background: List job title, organization, and dates of employment for your last three positions. For students, list student status (i.e., undergraduate or graduate), field of study, university, and dates of attendance.

How have you been involved in hazards mitigation or disaster management or otherwise contributed to your community and society?
(Limit 2400 characters or about 350 words)

What are your career goals?
(Limit 2400 characters or about 350 words)

How would you or your organization benefit from your attendance at the Hazards Workshop?
(Limit 2400 characters or about 350 words)

Please provide a brief statement of why you need financial assistance in order to attend the Hazards Workshop. Can you or your employer assume any of the cost? (Matching financial support is not a requirement for receiving the Mary Fran Myers Scholarship.)
(Limit 1800 characters or about 250 words)

Please click the button to submit your application: