Subject: Certification Scholarship

Effective Date: March 2002

Approved by: The Chicago Metro APIC Board

Revision Date: June 2003

Purpose: To promote certification and re-certification by offering an annual scholarship for the certification fee.

Procedure:

1. APIC Chicago will pay the cost of certification for one current member.

2. Scholarship applicants must pay the certification fees from their personal account.

3. Scholarship applicants must submit a copy of the certification.

4. Scholarship applicants must be current members of APIC Chicago and in good standing (i.e. membership dues paid).

5. Applications must be postmarked no later than November 23rd of the year in which certification or re-certification will take place.

6. Winners will be selected by random drawing from a pool of applicants.

7. Winners will be announced at the Annual Business Meeting and in the first newsletter thereafter.

APPLICATION FOR CERTIFICATION SCHOLARSHIP AWARD

Date: _________________

Name (last, first): ______________________________________________________

Healthcare Institution ________________________________________________

Job Title: ____________________________________________________________

Years of Certification: ________________________________________________

Signature ____________________________________________________________

Please attach a copy of the CBIC certificate and receipt for payment of certification.

Submit to:
Mary Alice Lavin, RN, MJ, CIC
328 Washington Street
Glenview, IL 60025