2014 Professional Association of Therapeutic Horsemanship International Riders Assistance Fund $300 Scholarship Nomination Form The purpose of this fund is to assist a child who would not otherwise be financially able to participate in a therapeutic horsemanship program at a PATH Intl. Premier Accredited Center. Thanks to the generosity of its donors, in 2014 PATH Intl. is able to fund one $300 need-based scholarship. Premier Accredited Centers, please complete this form, save and email to [email protected] . All nominations must be received at the PATH Intl. office by FEBRUARY 25, 2014 ! If you have any questions about this scholarship, please contact Megan Ferry, (303) 452-1212, ext. 107 or [email protected] . Thank you. Nominee information: Nominee’s Full Name: Nominee’s Home Address: City: State: ZIP/Postal Code: Day Phone: Evening Phone: Birth date (This scholarship is for children only, so the person must be born after January 1, 1996): Additional Information: Nominating PATH Intl. Premier Accredited Center: Address: Region: City: State: ZIP/Postal Code: