Institute for Healthcare Improvement Scholarship Application Thank you for your interest in IHI’s program. There is a limited amount of scholarship funding available to offset the fees of IHI programs in cases of financial hardship. Please note that scholarship funding is available to assist with program registration costs only and is not applicable for travel, food, or accommodation costs associated with attending the program. If you would like to apply for scholarship funding, please complete this application and return it by email to info@ihi.org. Have questions about this application? Call us at (617) 301-4800. Please note this application, and subsequent scholarship funding, is designed for the individual named below. Any additional applicants from your organization must complete a separate application. Name of Program: Applicant Name: Email Address: Phone Number: Organization Name: Job Title/Primary Role: Have you previously attended an IHI program? If yes, please list the name(s) of the program(s) you have attended. How much of the registration fee are you and/or your organization able to contribute?** **Please note that scholarship funding is available to assist with program registration costs only and is not applicable for travel, food, or accommodation costs associated with attending the program. 1 Given that scholarship funding is limited for this program, please describe why you are applying for financial assistance. You may also include additional information about why you want to attend the program, what you hope to gain from the experience, and your personal and professional objectives, including any prior involvement in health care improvement. Please be as specific as possible. Thank you for your interest in IHI’s programs and for taking the time to complete the Scholarship Application. 2