NCMHR Advocacy Days Application for Scholarship Funding: Please complete by April 15, 2024.
June 9-12, 2025, Washington D.C. We are staying at the Kellogg Center Hotel on the Gallaudet University Campus. In order to qualify for a scholarship this year, you need to attend 60% of the Advocacy & Policy meetings that are being held each Tuesday from 6-7:15 pm (EST); 3-4:15 pm (PST) beginning March 25. We look forward to your participation in the process. Zoom link to register: https://zoom.us/meeting/register/CwpQ-f_7SpOscv8OfScqlw More information about the meetings will be emailed to you after you complete this form.
Please include your address (work or home) and email which are needed to make appointments with senators and representatives from your state.
Name
*
First Name
Last Name
Work or Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Are you planning to come to D.C. for the Hill Visit?
*
Yes
No
I'm not sure at this time
I can only come if I receive a scholarship
Other
Organization
Phone Number
-
Area Code
Phone Number
NCMHR has limited funds to assist with expenses of participants. If you will be able to pay for your expenses, please just check "yes" and submit the form. You do not need to continue to fill this out. If you would like funding, we ask that you plan on the three actions listed below. Will you or your organization be able to pay for all of your expenses for this trip and stay in D.C.?
*
Yes. Then please complete registration and we will be sending you information on making payment soon (you do not need to compete this form).
No
I'm not sure at this time
1. Will you watch and send us any questions about our video, "Welcome to Hill Days 2025"? (which will be sent to you)
Yes
No
Other
2. Will you attend weekly Advocacy and Policy meetings starting March 25 on Tuesdays from 6 pm to 7:15 pm Eastern/3 pm to 4:15 PM Pacific to prepare for the Hill Days? 60% attendance required to receive a scholarship. We look forward to your participation in the process. Link to register for the zoom meetings: https://zoom.us/meeting/register/CwpQ-f_7SpOscv8OfScqlw
Yes
No
Other
3. Will you set up at least 3 visits with a congressperson (1) and senators (2)? We will provide instructions on how to set up appointments and guidelines for your visits. We will also let you know which congressional representatives we think are most important to visit. You may attend with others from your state. If there is no one else from your state, we will try to get people from other states to accompany you.
Yes
No
Other
Which of the following expenses would you need assistance with in order to attend? If you or your organization can provide at least partial support, we can give scholarships to more people. NOTE: ALL REQUESTS FOR SUPPORT NEED TO BE RECEIVED BY April 15, 2024.
Transportation to/from DC
Overnight room. Note: We have arranged for attendees to stay at the Kellogg Center Hotel on Gallaudet University campus June 9-12, 2025 for 3 nights only for at a rate of $199 plus tax each night.
Metro and other transportation around D.C., meals, and other misc. expenses
Would you like to eat these meals at the Gallaudet student cafeteria? NCMHR is providing breakfast and lunch on June 10 (day of meeting together at Gallaudet University); and breakfast on June 11 and 12.
Do you plan to stay at the Kellogg Center? Scholarship recipients are required to share a room with one other person (with 2 queen beds in the hotel room). If there is an extenuating situation where you cannot share a room, then reach out to us for accommodations.
Yes; I want to stay at the Kellogg Center. NCMHR has a contract for the hotel rooms. Let us know below what kind of room you need.
Yes; I would need a scholarship from NCMHR for my hotel room at the Kellogg Center
No, I will arrange my own place to stay and will travel to the Kellogg Center for meetings on campus. We will meet Monday evening from 7-9 pm, Tuesday from 9 am to 5 pm (mini-conference with lunch provided on campus), and Wednesday evening from 7-9 pm to prepare for going to the Hill..
Undecided
If you are staying at the Kellogg Center, do you require an ADA room?
Yes
No
Other
Please list the person you would like to share a hotel room with 2 queen beds. If you don't have anyone, please write your wishes/requirements for sharing a room with someone. We will let people know who else is looking for someone. If you share a hotel room, we will give you each a stipend of $100 to help pay for local travel and meals.
What amount do you estimate you will need in assistance to make it possible for you to attend for travel, etc.? Note: NCMHR is providing breakfast and lunch on June 10 (day of meetings at Gallaudet University); and breakfast on June 11 and 12. Please list what the amounts are for.
Please tell us why you would like to attend and your experience with mental health advocacy.
If you have comments or questions, please include them here, or email: info@ncmhr.org We are very glad you are considering joining us for these important days in D.C.
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