Skip survey header

KHIMA Student Scholarship Application Form

Part I: About the Applicant

Deadline for receipt of nominations is October 31st.

Please note that you will have the ability to save the application and return to work on it again at a later time.  You will see a link at the top of the second page.

1. Applicant Information *This question is required.
2. School Contact Information *This question is required.
3. Are you an AHIMA Member? *This question is required.
4. Which scholarship are you applying for? *This question is required.