WSHIMA Professional Development Scholarship Name * Name Name Name AHIMA ID Number * Email * Phone * Address * Address Address Address Address Address StateAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Address Write a statement stating the purpose of which the award will be utilized and how the award will further your HIM professional career * List/Summary demonstrating leadership and dedication to the HIM profession, AHIMA, WSHIMA and/or local association (i.e. by holding office, volunteering, etc.) * Professional Letter of Reference * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB Current resume * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB I hereby certify the information provided by me on this application is true and correct to the best of my knowledge. I agree to the conditions outlined above. * signature keyboard Clear If you are human, leave this field blank. Submit
