Scholarship: Disrupting Workplace Bias

Financial Aid Scholarship Application – July 15-17, 2020

Upon qualification, 1440 Multiversity is pleased to provide scholarships towards program tuition for those who qualify.

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* 1. GENERAL INFORMATION

Name

Email

Phone

Street Address

City and State

Zip Code

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* 2. Employment Information

Company, Organization

Title/Position

Describe Your Role

Organization Website

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* 3. Have you taken part in any programs, trainings or activities that reflect your commitment to your leadership development? Please list.

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* 4. Is your employer willing to pay for part of your tuition and accommodations?

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* 5. Please explain why you are applying for a financial-aid scholarship.

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* 6. What is your approximate average household income?

$0-$24,999

$25,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$124,999

$125,000-$149,999

$150,000-$174,999

$175,000-$199,999

$200,000 and up

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* 7. How will you share and/or apply what you learn with others?