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Alexander Eastman Scholarship Application

Scholarships are awarded based on need and availability.

Event Title *

Event Date *

// (mm/dd/yyyy)

Amount Requested *

I agree that if I get an award, my statements may be used in association with fundraising, publications and the NHADACA website *

Yes
No

First Name *

Last Name *

Credentials

Email *

Agency *

Title / Position *

Home Address *

Unit/Apt #

City *

State/Province *

Zip *

Phone *

NHADACA Member *

Yes
No

Are you retired, active military, or a student? *

Yes
No

If yes, which one?

Have you received a NHADACA scholarship in the past 12 months? *

Yes
No

If yes, when?

Which community do you live and/or work in? *

Derry, NH
Londonderry, NH
Windham, NH
Hampstead, NH
Chester, NH
Sandown, NH
Not listed - you are not eligible for this scholarship, visit nhadaca.org to see other scholarship opportunities

Please explain how an Alexander Eastman scholarship would assist you with your professional goals? *

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Alexander Eastman Scholarship Application