Scholarship Form

Scholarships are offered on a first come, first served option for Virginia providers, with preference to first time (or depending on demand, possibly second time) VGS conference attendees who are NOT geriatricians.  Awardees will be notified in mid-March. We especially want to encourage other health professionals to apply, in addition to MDs!

Meals, lodging, and travel are not included in this offer—only conference tuition.

Scholarship Application

Complete the form below to apply for a scholarship to the Annual Virginia Geriatrics Conference.

IMPORTANT: You must include your credentials on the application below or you will not be considered.

[contact-form to=’bionic.huff@gmail.com’ subject=’VGS Scholarship Application’][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Mailing Address’ type=’text’ required=’1’/][contact-field label=’Work Phone’ type=’text’/][contact-field label=’Mobile Phone’ type=’text’/][contact-field label=’Credentials’ type=’select’ options=’MD,DO,NP,RN,Pharmacy,PA,Other’/][contact-field label=’Are you a member of the Virginia Geriatrics Society?’ type=’radio’ options=’Yes,No’/][contact-field label=’Are you interested in ongoing geriatrics educational opportunities and CE or CME credits?’ type=’radio’ options=’Yes,No’/][/contact-form]