2017 DO YOU Facilitator Training -- Scholarship Application

About the DO YOU Facilitator Training:

DO YOU: Building Youth Resilience Through Creative Expression is a primary prevention strategy to address teen dating violence, sexual harassment, and bullying by promoting positive youth development and healthy relationships. This training is designed for adult facilitators and teen mentors (who are peer facilitators) interested in implementing DO YOU in their communities. This comprehensive training will equip you with all materials and experience necessary to successfully implement the 10-session DO YOU program locally with small groups of teens ages 13-16.

**The DO YOU Facilitator Training will be held on July 19th and 20th at the Action Alliance offices in Richmond, VA **

About Training Scholarships:

The Action Alliance seeks to create learning opportunities that are accessible to our diverse membership and allies. To that end, we are offering
scholarships to help cover the registration costs of the DO YOU Facilitator Certification Training. We will prioritize scholarship funds for people who identify as being from a historically marginalized and/or oppressed community. A limited number of community scholarships will be available for non-members for this conference.

Full registration scholarships will be provided for selected applicants. The scholarship does not cover overnight lodging or transportation. Upon receipt of scholarship notification, selected applicants will receive a registration code. Registration cancellation and no-show policies will be shared at that time.

The deadline for submitting a scholarship application is June 30th by 5:00pm. Decisions regarding scholarship applications will be made shortly after that. If you have any questions about scholarships or our process, please contact us at 804.377.0335 or email training@vsdvalliance.org.

**PLEASE DO NOT REGISTER UNTIL YOU RECEIVE YOUR DISCOUNT CODE! Refunds will not be available should you register and then receive a scholarship.**

Question Title

* 1. Please complete the information requested below. (some information is required)

Name: *

Organization & Position, if applicable:

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone number:

Question Title

* 2. Name of Teen Mentor to attend training (if applicable)
(please note a maximum of two teen mentors can attend per adult participant at no additional cost)

Name:

Age:

Email Address (if available):

Question Title

* 3. Name of Teen Mentor to attend training (if applicable)
(please note a maximum of two teen mentors can attend per adult participant at no additional cost)

Name:

Age:

Email Address (if available):

Question Title

* 4. Please describe your racial and/or ethnic identity:

Question Title

* 5. Do you identify as a member of a historically oppressed and/or marginalized group?

Yes

Comment

Question Title

* 6. Please check one:

I can attend this training only if I receive funds to cover the full cost.

I can attend this training regardless of any assistance you might offer, but assistance would be greatly appreciated.

Question Title

* 7. If selected for a scholarship, I am able to attend the in-person training on July 19th and 20th in Richmond, VA:

Yes!

I'll have to move some things around but it should work.

Question Title

* 8. How would attending this training enhance your ability to provide programming for youth in your community?

Question Title

* 9. Please describe where you plan to implement DO YOU in your community. (i.e. School system, Boys & Girls Club, Faith community, Youth group, etc.)

Thank you for completing this scholarship application! All applicants will be notified once decisions are made.

Question Title

* 1. Please complete the information requested below. (some information is required)

Question Title

* 2. Name of Teen Mentor to attend training (if applicable)(please note a maximum of two teen mentors can attend per adult participant at no additional cost)

Question Title

* 3. Name of Teen Mentor to attend training (if applicable)(please note a maximum of two teen mentors can attend per adult participant at no additional cost)

Question Title

* 4. Please describe your racial and/or ethnic identity:

Question Title

* 5. Do you identify as a member of a historically oppressed and/or marginalized group?

Question Title

* 6. Please check one:

Question Title

* 7. If selected for a scholarship, I am able to attend the in-person training on July 19th and 20th in Richmond, VA:

Question Title

* 8. How would attending this training enhance your ability to provide programming for youth in your community?

Question Title

* 9. Please describe where you plan to implement DO YOU in your community. (i.e. School system, Boys & Girls Club, Faith community, Youth group, etc.)

* 2. Name of Teen Mentor to attend training (if applicable)
(please note a maximum of two teen mentors can attend per adult participant at no additional cost)

* 3. Name of Teen Mentor to attend training (if applicable)
(please note a maximum of two teen mentors can attend per adult participant at no additional cost)