The DEAF GAIN LaRosh Scholarship Application Form

Full Application Form Accepted in American Sign Language or in Written English.
“The human brain does not discriminate between the hands and the tongue. People discriminate, but not our biological human brain.”

Dr. Laura Ann Petitto
SCHOLARSHIP PURPOSE

In alignment with the Kansas Association of the Deaf’s mission, which is to PRESERVE, PROTECT, and PROMOTE the civil, human, linguistic, and DEAF GAIN rights of Deaf Kansans, the Youth Sponsorship and the LaRosh Scholarship funded by the designated LaRosh Fund is herein known as the DEAF UP SCHOLARSHIP.

As declared during the 29th Biennial Convention in 1987, the visionary former KAD President Fred R. Murphy called for the fund to “ . . . benefit ALL the Deaf in the state, all the Deaf must benefit - not just a few,” and as outlined in the KAD 1987 Budget Guidelines written by former KAD Treasurer Richard Brubaker, the nephew of the deceased donor Frank LaRosh, “. . .the LaRosh funds shall be awarded to a Deaf Kansas Student . . .”

Therefore, following the spirit of Fred R. Murphy and Richard Brubaker’s vision in memory of Frank LaRosh’s generous bequest, the DEAF UP SCHOLARSHIP’s purpose is to award an individual scholarship(s) up to at least a minimum of $50 to a maximum of $6,000 annually, for as long as funds are available, to a Kansas Deaf student(s) ages 14 and up pursuing their education to ELEVATE, EXPAND, and ENHANCE their skills in their specific fields of interests, advocacy, and activism. As a result, Deaf leaders are created to contribute and influence the elevation and growth of Deaf Leaders, the Deaf Community, the Deaf Ecosystem and Human Diversity.

The DEAF UP SCHOLARSHIP can be awarded for personal skill building and educational endeavors such as but not limited to the following categories:
- Deaf Leadership Camps
- NAD Youth Leadership Camps
  - note for all applicants:
    A letter of ineligibility for funding from the Kansas School for the Deaf Endowment Association must be provided as proof before an applicant can be eligible for the DEAF UP Scholarship for this category.
- Deafhood Institute Trainings
- National Leadership Training Conferences
- National Black Deaf Advocates Conferences
- Multicultural Training/Conferences
- National Association of the Deaf Conferences
- Any Deaf Centered Conferences
- Skill-Specific Workshops/Seminars/Trainings
- Advocacy & Social Justice Trainings
- Parliamentary Trainings
- Entrepreneurship Trainings
- Deaf Centered Retreats
- Artivism Trainings/Workshops/Conferences
- Deaf Interpreters Trainings/Workshops/Conferences
- Deaf Studies, Intersectionality and Deaf Communities Courses
- Language fluency and Linguistics Workshops/Courses
- Film, Theatre, Arts and Media Workshops
- Social Media Deaf Influencers trainings/Workshops
- Legislation, Policy Making, Politics, and Campaign Trainings/Workshops
- Certificates or Degrees from Voc-Tech Schools, Community Colleges or Universities
  - note for all applicants:
    Letters of ineligibility for the Kansas State Department of Vocational Rehabilitation Services and for funding from the Kansas School for the Deaf Endowment Association must be provided as proof before an applicant can be eligible for the DEAF UP Scholarship for this category.
- and many more that influence and elevate the growth of Deaf Leaders, the Deaf Community, the Deaf Ecosystem and Human Diversity.
ELIGIBILITY CRITERIA
- Applicant must be 14 years or older and must have Deaf Gain. KAD will use the applicant's State issued ID or Driver's License as proof.
- Applicant must be a Kansas Resident. KAD will use the applicant's State Issued ID or Driver's License as proof.
- Applicant must be a member of KAD. The KAD Board will verify applicant's membership standing through its membership roster.
APPLICATION PERIOD: Applications are accepted at any time during the award year.
APPLICANT INFORMATION
Name of Applicant*
If selected as the winner, this name will be to whom the check will be issued to.
Text Number*
Please enter a valid phone number
Video Phone Number*
Please enter a valid phone number.
Email*
example@example.com
SCHOLARSHIP ELIGIBILITY REQUIREMENTS

The following must be provided for the application to be qualified for consideration.
Applicant acknowledges that applicant must be a KAD member to apply for this scholarship.*

YES, I confirm that I am a current member of the Kansas Association of the Deaf (KAD). I understand that membership is a prerequisite for applying for this scholarship. MEMBERSHIP REMINDER: If you are not currently a KAD member, please visit www.deafkansas.org/membership to join now with a $5 investment for a one-year membership.
Applicant's Date of Birth*

MonthDayYear
Applicant's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant's Proof of Date of Birth and Address:*

Please upload an image of your Drivers License or qualifying state ID.
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ENDEAVOR DETAILS

Provide as much information as you can to strengthen your chances of being awarded.
Endeavor Categories*

Deaf Leadership CampNAD Youth Leadership Camp (NOTE:a letter of ineligibility for funding from the Kansas School for the Deaf Endowment Association must be provided as proof before an applicant can be eligible for the DEAF UP Scholarship for this category)Deafhood Institute TrainingsNational Leadership Training ConferencesNational Black Deaf Advocates ConferencesMulticultural Trainings/ConferencesNational Association of the Deaf ConferencesDeaf Centered ConferencesSkill-Specific Workshops/Seminars/TrainingsAdvocacy & Social Justice TrainingsParliamentary TrainingsEntrepreneurship TrainingsDeaf Centered RetreatsArtivism Trainings/Workshops/ConferencesDeaf Interpreter Trainings/Workshops/ConferencesDeaf Studies, Intersectionality and Deaf Community CoursesLanguage Fluency and Linguistics Workshops/CoursesFilm, Theatre, Arts, and Media WorkshopsSocial Media Deaf Influencers Trainings/WorkshopsCertificates or Degrees from Voc-Tech Schools, Community Colleges or Universities (NOTE: letters of ineligibility for the Kansas State Department of Vocational Rehabilitation Services AND for funding from the Kansas School for the Deaf Endowment Association (KSDEA) must be provided as proof before an applicant can be eligible for the DEAF UP Scholarship for this category.)Other
Applicant's proof of ineligibility for funding from KSDEA or for Kansas Vocational Rehabilitation Services for the endeavor categories of the NAD Youth Leadership Camp, Voc-Tech, Community Colleges or Universities.

Upload copies of the letter(s)
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Award Amount Request*
type a dollar amount
Link to your personal website or social media account:
If available
Skill-building Endeavor Title*
Tell us about your skill-building Endeavor:*
If in ASL, please provide a link to the ASL version
Tell us how you will use the funds:*
If in ASL, please provide a link to the ASL version
Tell us how your skill-building Endeavor will influence or contribute to the elevation of yourself as a Deaf Leader, and to the expansion, enhancement of the Deaf community, the Deaf Ecosystem, and/or to Human Diversity:*
If in ASL, please provide a link to the ASL version
Tell us how your Endeavor aligns with KAD's mission, which is to PRESERVE, PROTECT, and PROMOTE the civil, human, linguistic, and DEAF GAIN rights of Deaf Kansans:*
If in ASL, please provide a link to the ASL version
Tell us about yourself:*
If in ASL, please provide a link to the ASL version
Upload supporting images or files of your Endeavor:

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AGREEMENT of the DEAF UP SCHOLARSHIP TERMS by Applicant.

Must be signed before applications can be considered and awards given.
The DEAF UP SCHOLARSHIP TERMS

If I am awarded, I agree to share my experience by doing one of the following plus attend to at least one KAD board meeting within three (3) months after completing my endeavor. I will work with the Deaf Up Board member on this.

1) Write an article for the KAD Newsletter

2) Create a vlog for the KAD Newsletter

3) Give a presentation at a KAD Board Meeting or event

If I do not perform one of the above within six (6) months of completing my endeavor. I will be expected to return the scholarship award to KAD.

If my request is awarded, by accepting this scholarship award, I agree to release the Kansas Association of the Deaf (KAD), and its officers, directors, and members from any liability, loss, damage, cost, or claim that arises from my participation in the scholarship program. KAD reserves the right to withhold awards in any given year, and to modify or terminate any scholarships at its sole discretion, with or without notice.

If my request is awarded, by accepting this scholarship award, I give the Kansas Association of the Deaf (KAD) permission to publicly announce my name, image, award amount, and endeavor in any of its public relations materials.

If my request is awarded, I understand that as the recipient of the DEAF UP SCHOLARSHIP I am solely responsible for any state or federal tax liabilities that may result from acceptance of the scholarship.
To be signed by the recipient named as applicant that the check will be issued to. By signing this document, the recipient agrees to the Deaf Up Scholarship Terms:
Applicant Signature*

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Applicant Name*

First NameLast Name
SCHOLARSHIP AWARD NOTICE:

Scholarship Award Criteria: Awarding of scholarships is contingent upon the strength of the application, fund availability, the proposed individuals' endeavor merit, and the volume of applications received. Receipt of a scholarship is not guaranteed.

Confidentiality Assurance: Personal details such as age, address, and driver's license number are treated with utmost confidentiality and will not be disclosed. Information pertaining to the awarded endeavor may be shared publicly.

Selection Process: The KAD Board of Directors convenes as requests come in, to evaluate and vote by majority to approve the request.

Announcement of Winners: The KAD Board of Directors will announce the scholarship recipient(s) on its website and may also utilize other available media/communications sources for announcements.
Should be Empty:

APPLICANT INFORMATION

SCHOLARSHIP ELIGIBILITY REQUIREMENTS

ENDEAVOR DETAILS

AGREEMENT of the DEAF UP SCHOLARSHIP TERMS by Applicant.