Ann Conlon Scholarship Application Form
Applicant Name: _________________________________________________________________
Job Title/Position: ________________________________________________________________
Library/Institution Name: __________________________________________________________
Mailing Address: _________________________________________________________________
_____________________________________________________________________
Office phone: (_______)_____________________ Fax: (_______)_________________________
E-mail: _________________________________________________________________________
Educational Opportunity/CE / Meeting: _______________________________________________
Dates of Event/Class: _____________________________________________________________
Location of Event/Class: __________________________________________________________
Estimated Total Cost of Educational Opportunity: $____________
Please include a brief paragraph below on what you believe the benefit of this education will be to your professional
development. The TaBaMLN Governing Board will review this application and inform you of acceptance ASAP.
Return this application form and supplemental materials via email to TaBaMLN Treasurer Dorthy Kelly; email:
dorthy.kelly1@va.gov
The Ann Conlon Scholarship is an educational scholarship awarded by TaBaMLN to expand access to continuing education
opportunities for TaBaMLN members. The scholarship is named in honor of Ann Conlon, one of the early members of TaBaMLN
in recognition of her contributions in the development of the consortia and leadership in the advancement of medical
librarianship in the Tampa Bay area.
We also encourage our librarians and/or assistants to contact our Governing Board to request CE tuition aid from this ACS fund
for CE expenses not sponsored by TaBaMLN, e.g., FHSLA, SCMLA, MLA.
Please note that this ACS fund is not to be used for travel, food, or lodging. Recipients will be reimbursed for their CE expenses
from this ACS fund after presenting a report on the course(s) they attended to TaBaMLN’s next meeting.