Doreen Pollack Scholarship

PLEASE PRINT THE COMPLETED FORM AND MAIL TO AVI

Application for Doreen Pollack Scholarship assistance for continuing education
in the
Auditory-Verbal approach.

Name
Degree
Professional Title
Institution
Preferred Mailing Address
City/State/Zip
Daytime Telephone
(Area Code + Number + Extension)
How long have you been a member of AVI, Inc.?

Please include the following:

  1. Current resume and job description.

  2. A letter of recommendation from an employer, supervisor, or university professor attesting to your character, commitment to the Auditory-Verbal philosophy and potential talent as an Auditory-Verbal Therapist.

  3. A statement of financial need for scholarship assistance.

  4. A statement explaining how this scholarship will be used and how it will enhance your career goals. 

  5. Any other background information which you feel will be supportive of your application such as professional affiliations, publications, conferences attended additional letters of recommendation (e.g. from a parent of a child with hearing impairment).

Please sign and date this application andreturn it to the AVI office by August 1.

Executive Director
Auditory-Verbal International, Inc.
2121 Eisenhower Avenue, Suite 402
Alexandria, VA 22314

Signature Date

 

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