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2023 Scholarship Application
Scholarships for survivors of childhood sexual abuse and their loved ones are generously sponsored by Lisa Levin Appel in honor of Marilyn Van Derbur Atler.
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1.
Contact Information (This information and all info below is confidential and for application purposes only. We will not share this information with anyone, and it will NOT appear on any event publications, name tags, etc.)
Please provide the email address that you plan to use to register for the Race for Healing. Scholarship communication will also be sent to this same email.
(Required.)
Email Address:
First Name:
Last Name:
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2.
Why would you like to participate in this year's Race for Healing?
(Required.)
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3.
Please briefly describe the financial need that is prompting your scholarship request.
(Required.)
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4.
How much would you feel comfortable contributing toward your registration? ($0 - $35)
(Required.)
