Consumer Scholarship Application Form

Consumer Scholarship Application Form

NADA Conference 2020 Scholarship Program
Applications close by 5pm, Friday 24 April 2020.

If you would like support to complete this application, phone Michelle Ridley on (02) 8113 1306 or 0413 748 453 or email michelle@nada.org.au
Name *

First Name Last Name
Phone number *

Area Code Phone Number
Email *
example@example.com
Have you attended a NADA conference before? *

Yes No
Do you identify as Aboriginal or Torres Strait Islander? *

Yes No
Do you identify as culturally or linguistically diverse? *

Yes No
Do you identify as sex, sexuality and/or gender diverse? *

Yes No
Describe your experience as a consumer of alcohol and other drugs treatment services? *
(No word limit)
Why would you like to attend the conference? *

(max. 100 words) 0/100
What do you hope to gain from attending? *

(max. 100 words) 0/100
Will you require travel support to attend the conference? Please detail. *
(No word limit)
By submitting this form, I understand that this application does not guarantee confirmation of scholarship to attend the NADA Conference 2020
Should be Empty: