Choosing to Lead Scholarship

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:

A community member

A college student

A high school student

A middle school student

A parent/educator

I am a parent/educator nominating someone else for a scholarship (please list their name below)

Other (please comment below)

Comment:

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* 5. Are you applying for a:

Partial Scholarship

Full Scholarship

We are working hard to make Choosing to Lead accessible to everyone, but have a limited number of full scholarships available. How much, if anything, would you be able to contribute to conference registration?

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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?

Yes

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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?

Yes