Consumer Scholarship Application Form

Consumer Scholarship Application Form

NADA Conference 2021 Scholarship Program
Applications close by 5pm, Friday 5 March 2021.

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 2021
Should be Empty: