The Student Voices Summit & Screening will take place in Los Angeles on April 29, 2017, from 10:30am - 5pm. Students are eligible to receive travel stipends for themselves and a chaperone to travel to Los Angeles for the event. Priority will be given to students who submit a video for the 2017 Student Voices Campaign, though all are welcome to apply. For information about the Student Voices Campaign, visit StudentVoicesCampaign.org.

In order to be approved for a stipend:
1) Each attendee (students plus chaperone) must be registered through the event registration page at http://StudentVoicesSummit2017.eventbrite.com.
2) Attendance must be confirmed at the Student Voices Summit & Screening on April 29, 2017.
3) 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).

Questions? Email melissa@artsed411.org or call 626.578.9315 ext. 104.

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* 1. Adult Full Name

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* 2. Email

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* 3. Phone

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* 4. Are you a parent or a teacher?

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* 5. How many students will you bring?

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* 6. School/Organization

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

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* 8. What city are you traveling from?

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

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* 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).

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* 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.

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