Media Transformation 2018 Scholarship Application

This offer is limited to 2 people per company. LMA board members are not eligible.

1. Name of person nominating *This question is required.

2. Title of person nominating *This question is required.

3. Company of person nominating *This question is required.

4. Email Address of person nominating This question requires a valid email address.

5. Scholarship applicant’s name

6. Scholarship applicant’s title

7. Scholarship applicant’s company

8. Scholarship applicant’s email address This question requires a valid email address.

9. What qualifies you for a diversity scholarship? *This question is required.

Race
Ethnicity
Gender
Sexual orientation
Work for a small media company
Disability
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

10. Please acknowledge that this candidate will be able to attend the full conference (starting at noon on Tuesday, 9/25 and ending at 11:30 AM on Thursday, 9/27). *This question is required.