Skip survey header

NWA Scholarship Application - 2022 Virtual NWA National Policy Conference

Thank you for applying for a National WIC Association (NWA) Member Benefit Fund Scholarship!

This application will take about 5-10 minutes to complete. You may pause, save your answers and return to it at any time by using the "Save and Continue" feature that appears on the top of the second and following pages.  


This application MUST be submitted to NWA by 11:59 PT Friday, January 21, 2022. No late applications will be accepted. 

In order for this application to be completed, your supervisor will need to confirm their support. Your supervisor's contact information will be collected in this application and NWA will reach out to them to confirm their support.
1. Before you start, please confirm that you are: *This question is required.
Space Cell Check box to confirm
a currently employed WIC agency/clinic staff member
a current member of NWA (this is likely an agency-level membership)
3. Agency Type (Please check all that apply) *This question is required.
Is your State Agency an Indian Tribal Organization (ITO)? *This question is required.
5. Agency Location (please choose what fits best) *This question is required.
6. Applicant Information
This question requires a valid email address.
This question requires a valid email address.
In order for this application to be considered complete, your supervisor will need to confirm their support. NWA will reach out to your supervisor once you have submitted this form to confirm their support.