2019 CPL Summit Scholarship Application Question Title * 1. Contact Information Name * Company * Address * Address 2 City/Town * State/Province * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code * Country * Email Address * Phone Number * Question Title * 2. Which summit are you applying for? (note: some summits are not open yet for scholarship applications) CPL Summit | MIDWEST (Oct 10-12 in Cincinnati, OH) Question Title * 3. Which day(s) do you plan on attending the summit? Day 1 Day 2 Day 3 Question Title * 4. Do you identify as any of the following? (check all that apply) Rural community member Person of color Person from a lower and moderate income background LGBTQ+ community member Immigrant Member of an Indigenous Community Local artist Survivor of abuse and/or trauma Woman Other (please specify) Question Title * 5. Do you work with any of the following underrepresented groups? (check all that apply) Rural community members People of color People from a lower and moderate income background LGBTQ+ community members Immigrants Members of an Indigenous Community Local artists Survivors of abuse and/or trauma Women Other (please specify) Question Title * 6. Briefly describe your work or studies, as it relates to creative placemaking. Limit 150 words. Question Title * 7. What do you want to learn more about at the summit? Limit 150 words. Question Title * 8. What impact do you hope to achieve in your community by attending the summit? Limit 150 words. Question Title * 9. Who do you need to connect to in order to further the reach, impact, or scope of your project/organization? Question Title * 10. What knowledge or experiences can you provide the summit participants? Limit 150 words. Question Title * 11. Would you like to say anything else in support of your scholarship application? Limit 150 words. Question Title * 12. How did you hear about the CPL Summits? Recommended by NCCP Recommended by ArtPlace America Recommended by a Planning Committee Member General Word of Mouth Social Media Website E-blast Other (please specify) Done