The Student Voices Summit & Screening will take place in Los Angeles on April 29, 2017, from 10:30am - 5pm. Students who participate in the 2017 Student Voices Campaign are eligible to receive travel stipends for themselves and a chaperone to travel to Los Angeles for the event. For information about the Student Voices Campaign, visit

In order to be approved for a stipend:
1) Students must participate in the 2017 Student Voices Campaign by submitting a video at by the April 1, 2017 Campaign deadline.
2) Each attendee (students plus chaperone) must be registered through the event registration page at
3) Attendance must be confirmed at the Student Voices Summit & Screening on April 29, 2017.
4) Receipts and/or appropriate documentation for travel plans must be submitted for stipend disbursement. Detailed instructions will be sent to approved stipend recipients.

A limited number of travel stipends are available and will be awarded on a first come, first served basis. Stipend amounts will be based on the location traveled from and number of students attending. Stipend recipients will receive confirmation and detailed instructions after submitting a stipend application.

We ask those flying in from SFO, OAK, and SMF to arrive the morning of the event and book return flights the same evening. A limited number of overnight hotel accommodations are available only for those traveling by car for over 3 hours each way.

Stipend applicants must be an adult chaperone (at least 21). The deadline to apply for a stipend is March 29, 2017.

Questions? Email or call 626.578.9315 ext. 104.

* 1. Adult Full Name

* 2. Email

* 3. Phone

* 4. Are you a parent or a teacher?

* 6. School/Organization

* 7. School District (write N/A if from a youth organization)

* 8. What city are you traveling from?

* 9. Will you be traveling by car or by plane?

* 10. Explain briefly why you and your students would like to attend the event and why you are in need of a travel stipend (about 2 - 4 sentences).

* 11. I certify that I am over 21 years of age and understand that stipends will be awarded on a first come, first served basis, after appropriate documentation is submitted, and disbursed no later than May 15, 2017. By typing my name here, I am signing this application electronically. I agree that my electronic signature is the legal equivalent of my manual signature on this form.