FLF Form (move to page when open)

* Indicates required field

First and Last Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

University *

Phone Number *

I am a (select 1) *

Undergraduate student Masters student Ph.D. student

Discipline/Field of Study *

I am (for assigning roommates) *

Male Female

1A. Please list or describe your international experience. (150-250 words) *

1B. (Optional) Please describe your interest and/or experience in issues relating to this year’s conference theme “Business "Un"usual: Aligning Critical Intersections of Food, Agriculture, and Health” (100-200 words) *

2. Please list any Academic/Professional awards or honors that you have received, which you feel are relevant to this AIARD FLF application. *

3. Please write a brief statement of your career interests and goals to include any international aspirations. (200-300 words) *

4. Please describe the value and benefit you would receive by participating in the Future Leaders Forum. (100-200 words) *

I am available to attend the entire AIARD conference, beginning at approximately 3:00 PM on Sunday, June 3 and will stay through the end of FLF programming on Wednesday, June 6 (departing DC on June 7). *

Yes No

I understand that the FLF Scholarship will cover hotel and conference registration. FLF students or their institutions are responsible for airfare to and from Washington, DC (We recommend flying into DCA) and transportation to/from the airport/hotel. *

Yes No

If selected, I am willing to give a short presentation and/or present a poster on my research or area of interest during the conference. *

Yes No

I agree to receiving marketing and promotional materials