HTA-CA Travel Grant Application » Hand Therapy Association of California

Purpose

The purpose of the HTA-CA Travel Grant is to assist therapists traveling outside of the US who will be:

Providing health care services or education in underdeveloped countries or disaster areas.
Promoting the profession of hand therapy
Participating in a medical mission through a volunteer organization

Guidelines

The applicant must be a Certified Hand Therapist and an Association member for at least 1 year prior to receiving the grant.
Preference may be given to those with volunteer experience in one of the committees of the association.
The applicant must be an actively practicing licensed hand therapist and show verification of employment.
The applicant will need to be in a position to travel during the year the grant is allotted and travel dates defined.
The applicant will be responsible to prepare a clinical article to submit to HTA-CA and a presentation within six months of the volunteer experience.
Please submit copies of all expenses for reimbursement. Expenses will be reimbursed as decided by the review committee between 1-$1500. A pre-requested amount may be approved and disbursed after the mission. In special cases, funds may be provided in advance of the mission for supply purchase.
Reimbursed expenses can include: medical-splinting supplies, transportation, and accommodations. All moneys will be awarded after the trip on submission of receipts and presentation to the association. Presentation may be made at the Hand Therapy Week or as a Virtual Monthly Seminar.
HTA-CA does not assume liability or financial responsibility for any medical expenses related to illness or injury or loss of personal items during your travels.
Application will be reviewed and voted on by the HTA-Ca board and Committee members. Members receiving the grant will be informed via email.
Grant can be given to previous recipients once a year. More than one Grantee may selected in a year.

Name*
First Last
Email*
Phone*
Volunteer Opportunity Location:*
Include country, hospital, organization etc.
Why you should be granted the money, i.e. how does your mission further the hand therapy profession? :*
(Up to 300 word essay)
Sponsoring agency (Interplast, HVO, church, hospital group)*
Provide links to organization websites
Amount requested by Grantee*
Sponsoring agency's contribution*
Funds will be spent on:*
(list supplies, travel expenses etc)
Physician Reference:
Physician Reference Name*
First Last
Physician Reference Email*
Physician Reference Phone*
Therapist Reference:
Therapist Reference Name*
First Last
Therapist Reference Email*
Therapist Reference Phone*
Years as OT / PT/ CHT*
Languages you speak*
What is the purpose of your trip?*
(teach, formal seminar, mission/surgical trip)
What other volunteer positions have you held?*
Have you volunteered for HTA-CA?*
- Yes
- No
If yes, please provide with detail on what position held and for how long:*
Are you a member of HTA-CA?*
- Yes
- No
If yes, for how long?*
Additional Comments:
Upload Resume
Accepted file types: pdf, doc, docx, Max. file size: 20 MB.

Purpose

Guidelines

Physician Reference:

Therapist Reference: