EmailMe Form - Corris PA Davis Attendee Scholarship (UMBC MCNAIR)

University Official Information

This form must be completed by Program Director/Coordinator or University Official

Year *

2026

University Official's Name *

First Last

University *

Program/Office *

Position/Title *

University Official's Email *

Confirm University Official's Email

Student Infomation

The student attendee's information should be enter here

Student's Name *

First MI Last

Student's CellPhone Number *

### - ### - ####

Student's Email *

Student's Email Confirm

Student's Major *

Desired Registration Type *

Presenter - Oral

Presenter - Poster

Attendee Only

Projected Graduation Date *

MM / YYYY

Reason for Need
Please have the student submit to you their reason for need and why they want to attend the conference, and provide details on how they will contribute to your community from attending this conference (cut & paste here, length doesn’t matter, content does) *

Please paste the response from the student to this question:
How have you strived to be a Transformative Scholar? *

Please paste the response from the student to this question:
What does “flourishing in the academy” mean to you at this stage of your journey, and what practices or supports help you move toward that vision? *

Please Upload Photo of the student that they wish for us to use in promotional materials. *

Brief Bio of the Student *

This bio will be used in promotional items. Should be no more than 100 words.

I hereby support this submission as we have exhausted all funds to support this student. *

Clear