Producer Scholarship Application F-J
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1. Application for Producer Scholarship

Dear Applicant:

We are delighted you are interested in attending the historic Fair Trade Futures Conference, in Boston, Massachusetts, from September 10-12, 2010.

Please take 20-30 minutes to complete this short application. The conference seeks to have people from diverse backgrounds and Fair Trade experiences attend. So, your truthful answers to the questions below will help us appreciate how you would bring a different voice to the conference.

Notable dates are:

March 15, 2010 – scholarship recipients announced from Round 1
July 15, 2010 – scholarship applications due for Round 2
July 30, 2010 – scholarship announced from Round 2

For further information about the scholarship program, or Fair Trade Futures Conference, visit www.FTRN.org

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1. Please complete the following personal information:

	Sex	Age	Region Where You Work
Your	Please complete the following personal information: Your Sex	Age	Region Where You Work

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2. What types of Fair Trade products do you make? (Check all that apply)

What types of Fair Trade products do you make? (Check all that apply) Agricultural products Handmade products	Other
Please specify:

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3. Please provide us your residential address and contact information below:

Please provide us your residential address and contact information below: Applicant Full Name:
Residential Address 1:
Address line 2:
City/Town:
State/Province:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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4. Please provide us your work address and contact information below:

Please provide us your work address and contact information below: Name of Fair Trade Organization You Are Affiliated With:
Name of Your Employer
Address 1:
Address line 2:
City/Town:
State/Province:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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5. How long have you been involved with Fair Trade:

	Less than 2 months	2 to 5 months	6 months to 1.5 years	1.6 to 5 years	More than 5 years
Fair Trade	*How long have you been involved with Fair Trade: Fair Trade Less than 2 months	Fair Trade 2 to 5 months	Fair Trade 6 months to 1.5 years	Fair Trade 1.6 to 5 years	Fair Trade More than 5 years

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6. Describe any activities, and name any organizations, with which you've been involved in Fair Trade (answer in up to 100 words):

Describe any activities, and name any organizations, with which you've been involved in Fair Trade (answer in up to 100 words):

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7. What are your primary goals in attending the conference (answer in up to 100 words)?

What are your primary goals in attending the conference (answer in up to 100 words)?

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8. What other sourcing of funding are available to you to assist you in attending the conference (examples: personal funds, employer support, family support, etc.):

What other sourcing of funding are available to you to assist you in attending the conference (examples: personal funds, employer support, family support, etc.):

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9. At what level do you speak and understand English language conversation? (If not, translation services may be available)

At what level do you speak and understand English language conversation? (If not, translation services may be available) Basic

Medium

Advanced

Comment if you wish:

10. Any other factors you'd like us to consider with this application?

Any other factors you'd like us to consider with this application?

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Producer Scholarship Application F-JExit this survey

1. Application for Producer Scholarship

*1. Please complete the following personal information:

*2. What types of Fair Trade products do you make? (Check all that apply)

*3. Please provide us your residential address and contact information below:

*4. Please provide us your work address and contact information below:

*5. How long have you been involved with Fair Trade:

*6. Describe any activities, and name any organizations, with which you've been involved in Fair Trade (answer in up to 100 words):

*7. What are your primary goals in attending the conference (answer in up to 100 words)?

*8. What other sourcing of funding are available to you to assist you in attending the conference (examples: personal funds, employer support, family support, etc.):

*9. At what level do you speak and understand English language conversation? (If not, translation services may be available)