Scholarship Application for Deafblind Core Teams
The Kansas DeafBlind Project provides scholarships to service providers working with students who have combined vision and hearing loss (deafblind). These scholarships can be used to attend any deafblind-related training, conference, or workshop.
Name of Individual Requesting Scholarship
*
First Name
Last Name
Job title/Role
*
Email
*
example@example.com
School District
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Event (Include website & registration link with available)
*
Date of Event
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Registration Cost
*
Total Cost Requested
*
Why do you want to attend this event?
*
How are you planning to use the information gained from the event?
*
How many students with DB will benefit from this event?
*
Additional Comments
Submit
Should be Empty: