PENNSYLVANIA INTRAMURAL & RECREATIONAL SPORTS ASSOCIATION
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PIRSA Membership Form
Scholarship Application
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Indicates required field
Name
*
First
Last
Institution
*
Email
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Phone Number
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Year in School
*
FR
SO
JR
SR
Grad
# of Years working for Recreation
*
1
2
3
4+
Major
*
GPA
*
NIRSA/PIRSA Involvement
*
Please list any involvement you have had with NIRSA/PIRSA (outside of attending a conference)
Which NIRSA event were you looking to attend and why?
*
Please describe in 250 words what is the most important thing you hope to obtain at the conference.
Name of Reference
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Reference's Email
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Reference's Phone Number
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Home
About
History
>
Leadership History
State Workshop History
Officers
>
PIRSA Board Application
PIRSA Events
Information for Members
PIRSA Membership Form