2017 Western Forum for Migrant & Community Health Stipend Application
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Northwest Regional Primary Care Association is able to offer a limited number of stipends to qualifying individuals and organizations.  A maximum of two full stipends (tuition and travel) will be awarded per organization.

Application deadline is November 30, 2016
Applications received after this date will not be considered. 
Stipend awards will be announced December 14, 2016.  

Please fill out the form below to complete the stipend application.  If you have any questions, or need help finding your organization's tax ID, please email Krista Chuscavage - kchuscavage@nwrpca.org.

Please note
that stipends are intended to help frontline staff (e.g. community health workers, promotores/as, outreach workers, patient navigators) from community and migrant health centers to attend the conference.  Priority will be given to those individuals.


  • Applications are due November 30, 2016
  • You may apply for one or both stipends
  • If you are applying for a stipend, do not register for the Forum at this time; if your application is accepted, you will receive registration instructions with your award notification
  • If awarded a tuition stipend, it will be applied to the registration fee
  • Travel stipends will be sent out after the conference.  Only individuals traveling more than 30 miles to attend the conference are eligible to receive a travel stipend

If you are applying for the travel stipend, you must complete the below questions in order to be considered. 

If your organization is paying for attendee travel, please provide Organization Tax ID # below.  If the applicant is paying for travel, please provide the attendee's Social Security Number.

This information is required in order for NWRPCA to issue a check refund.

If you have trouble locating your organization's tax ID #, please email Krista for assistance.

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