Thank you for your interest in Choosing to Lead! Please complete all fields below in full. Please contact Stephanie Chewning at 201-960-7066 or email stephanie@onehundredmiles.org if you have any questions or need additional information.

Scholarships are non-transferable and will be awarded on a rolling basis and as funds allow.

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* 1. Name:

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* 2. Email Address:

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* 3. Phone Number

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* 4. Are you:

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* 5. Are you applying for a:

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* 6. How would you (or your nominee) benefit from attending Choosing to Lead?

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* 7. We are recruiting volunteers to help with various roles throughout the conference. Would you be willing to help as part of your registration?

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* 8. We have limited scholarship dollars available. If you are awarded a scholarship, will you commit to attending and participating in the full day?

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