ALTERNATIVES 2014 SCHOLARSHIP APPLICATION
VOCAL is offering scholarships for registration and lodging to its members for Alternatives 2014 on October 22-26, 2014 being held in Orlando, FL. There are a limited number of scholarships available and preference will go to those who have not received a scholarship in the past; however, don’t let that discourage you from applying. Please complete this form and email it to or fax to 804-343-0160 by close of business on Monday, 10/6/14.
Name:
Address:
Phone #: Email:
Gender: Male Female
Demographic Information (optional): Indicate applicable answers.Age / Ethnicity / Veteran / Physical Disability / Sexual Orientation
18-26
27-39
40-55
56+ / Asian/Pacific Islander
American Indian
Black
Hispanic
White
Other / Yes
No / Yes
No / Heterosexual
Gay
Lesbian
Bisexual
Are you able to cover your transportation costs to Alternatives 2014 in Orlando, FL?
Yes No
Have you received a scholarship from VOCAL to Alternatives in the past?
Yes No
Additional Information:
Scholarships are based on need and interest. By applying, you are indicating that the cost of the conference would present a financial hardship for you. Please answer the following questions on a separate sheet of paper.
1. In one paragraph, describe why you are interested in attending the Alternatives 2014 conference?
2. How will you disseminate information obtained at this conference to local or statewide consumer groups?
3. Describe your knowledge and experience in the area of peer services?
4. Are you currently involved with any related programs or activities? If yes, please describe.
5. Describe how you plan to use your experience to contribute to the conference?
Scholarship Conditions:
1. You are responsible for arranging your own transportation to the conference.
2. If you are awarded a scholarship, VOCAL requests that you provide a written summary your experience with at least one workshop in which you attended within one month of the conclusion of the conference.
3. Inform VOCAL staff if you are unable to attend the conference or will be delayed in meeting the above condition.
This scholarship was made possible with funding from DBHDS.