Toni Chayra Memorial Travel Scholarship for Single Parents with Dependent Children

Established by ACPA member Dr. Garey Chayra in memory of his mother Toni Chayra, a working single mother. This scholarship aims to lessen the financial barriers for a single working parent to attend ACPA’s Annual Meeting.

This scholarship provides one $1,000 award annually to a single parent from the United States working in the cleft and craniofacial field who does not have access to institutional support for continuing education. The award shall be used toward meeting registration, travel, and lodging expenses related to ACPA’s Annual Meeting. The recipient will also receive a one-year ACPA professional membership.

Applications are due Friday, January 31, 2025.

1. Applicant Information

First Name *This question is required.

Middle Name

Last Name *This question is required.

City *This question is required.

State/Province *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number

2. What is your specialty? *This question is required.

3. Are you a single parent of at least one dependent child? *This question is required.

4. Please list the number and ages of all dependent children living with you. *This question is required.

5. Are you currently a member of ACPA? *This question is required.

6. Have you ever attended ACPA's Annual Meeting? *This question is required.

7. Most Recent Education
*This question is required.

School/Institution
Graduation Year
Degree

8. Do you have any additional schooling? *This question is required.

Additional Education

School/Institution 2
Graduation Year 2
Degree 2

Do you have any additional schooling?

Additional Education

School/Institution 3
Graduation Year 3
Degree 3

9. Current Employment *This question is required.

Institution
Position

10. Does your current employer pay for any continuing education? *This question is required.

Please enter an 'other' value for this selection.

11. Number of weekly hours in current position. *This question is required.

12. Number of years in cleft/craniofacial field. *This question is required.

13. Current Practice
Please describe your current responsibilities. *This question is required.

14. What are your professional goals? *This question is required.

15. ACPA Annual Meeting Goals
Please list your goals for attending ACPA's 2025 Annual Meeting. *This question is required.

16. How will receiving this scholarship help you to achieve your professional goals? *This question is required.

17. Please attach your CV/resume. *This question is required.

File: {{filename}} delete

18. Please attach a reference letter. *This question is required.

File: {{filename}} delete

19. I verify that this application was completed accurately by the person named below. *This question is required.

Clear

Signature of

Toni Chayra Memorial Travel Scholarship for Single Parents with Dependent Children - 2025 Application