Arizona/New Mexico 2024 Board Certification Scholarship Application

Applications are only  evaluated if all questions are completed and all requested attachments are included. If you need to come back to the application, click the "Save/Complete" button at the bottom, and when you return to the link the application will allow you to pick up where you left off. To complete the application, click "Save/Complete". The deadline to complete the application is Monday, December 2, 2024. Applications will be awarded in mid-December 2024. If you have questions, email aznmchapter@mgma.com. 

Thank you to Fresh Healthcare Advisors for providing the scholarships!

Question Title

* 1. Contact Information

First Name *

Last Name *

Address *

Address 2

City/Town *

State *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *