2025 ACMPE Scholarship Application

All completed applications will be evaluated by MGMA. Applications are only evaluated if all questions are completed and all requested attachments are included. If you need to come back to the survey, click the "Save/Complete" button at the bottom, and when you return to the link the survey will allow you to pick up where you left off. To complete the application, click "Save/Complete".

The deadline to complete the application is May 2, 2025. Funds will be awarded in early August 2025. If you have questions or require accommodations for a disability, email scholarship@mgma.com.

Question Title

* 1. Contact Information

First Name *

Last Name *

Address *

Address 2

City/Town *

State *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

Question Title

* 2. Gender

Male

Female

Non-binary/non-conforming

Transgender

Something else

Prefer not to respond

Question Title

* 3. Ethnicity

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Something else