Rising MAPA Leaders’ Scholarship Application - Minnesota Academy of Physician Associates

1. Name:(Required)

2. Email Address:(Required)

3. Current professional roles/titles:(Required)

4. Number of years in PA practice:(Required)

5. MAPA Membership and/or Involvement (past/present):(Required)

6. List any leadership roles (past/present) that pertain to the PA profession. If you are an early career PA, you may skip to question 7:

7. List any additional leadership experience or training that may be outside the PA profession:(Required)

8. In 350 words or less, please provide a personal statement explaining why you are applying for this scholarship. Describe your commitment to and potential for leadership within the PA profession, including examples of your leadership experience or contributions. Explain why this specific conference is meaningful to your development and how you anticipate applying what you learn to your current and future roles as a PA leader. Be sure to highlight your aspirations for leadership within MAPA and your personal vision for the future of the organization.(Required)

9. Please attach CV/resume for review.(Required)

Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 10 MB.

Accepted file types: PDF, Word, JPG, PNG. Max 10 MB.