2024 AK CCM Scholarship Application
To be eligible for a scholarship, you must be a member of an Alaska Child Advocacy Center Multi-Disciplinary Team partner.
Applicant Info
Applicant Name
*
First Name
Last Name
Employer
*
Email
*
example@example.com
Which CAC's Multi Disciplinary Team are you a member of?
*
Who should the reimbursement check be made payable to?
*
Mailing Address
*
Which is your desired registration (ticket) type?
*
Main Conference + Full Day Post Conference ($650)
Main Conference + Half Day Post Conference ($600)
Main Conference Only ($500)
Full Day Post Conference Only ($100)
Half Day Post Conference Only ($50)
Total Requested Amount
*
How will this training benefit your work with the CAC/MDT?
*
I understand that:
I (or my employer) will need to pay the costs up front. Upon full and successful completion of the conference, I will provide ACA with the receipt of payment and certificate of attendance. If the above conditions are met, ACA will submit reimbursement by check.
Submit
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