Scholarship Application
Justice. Healing. Liberation.

Scholarship Application Justice. Healing. Liberation.

Justice. Healing. Liberation.
May 2-4, 2018
Virginia Crossings Hotel and Conference Center
1000 Virginia Center Pkwy, Glen Allen, VA 23059

The Action Alliance is committed to prioritizing the work and voices of those who have been historically marginalized and oppressed in society and in our movement. As such, we seek to create learning opportunities that are accessible to our diverse membership and allies and are offering a limited amount of partial scholarships to help cover the cost of registration ($250) for the 2018 Justice. Healing. Liberation. to assist those who would not be able to attend otherwise.

To lift up our commitment to becoming an anti-racist organization, scholarships are prioritized for People of Color and Native people. We will also prioritize scholarship funds for people from other historically marginalized and/or oppressed communities. If you would like to be considered for a scholarship, please complete this form and you will be contacted with instructions for registration.

If you have any questions about scholarships or our process, please contact us at 804.377.0335 or email lwinsor@vsdvalliance.org

Question Title

* 1. Please complete the information requested below.

Name: *

Organization & Position: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Phone Number: *

Email Address: *

Question Title

* 2. This is the first time I've requested a scholarship to attend training from the Action Alliance.

Yes

Question Title

* 3. If you identify as a member of an historically marginalized and oppressed community, please describe:

Person of color

Native/Indigenous person

Immigrant and/or refugee

LGBTQ+

I don't identify as a member of an historically marginalized and oppressed community

Other (please specify)

Question Title

* 4. I have worked in this field for ____ years.

less than 1 year

1-3 years

4-9 years

10-15 years

more than 15 years

Question Title

* 5. Please describe how attending the Justice. Healing. Liberation. will be beneficial to you in your work to address sexual and domestic violence.

Thank you for completing this scholarship application! An Action Alliance staff member will be in contact with you by April 5, 2017 with a decision.