Name: Date of Birth: Email: Address: Preferred Form Do You Require Accessible/ of Communication: Alternate Formats? Have You Ever Attended the APRIL Conference? Yes No Are you currently a student? __Yes No This event is being held on a school day; can you obtain an excused absence? __Yes ___ No If you are awarded the Conference Scholarship, your registration will be paid. If you require other funding (such as lodging, transportation, etc.) please indicate this need below. Your need will not disqualify you from being awarded the scholarship. _________ Lodging _________ Other Need (please specify below) _________ Travel to include: ______ Plane Ticket ______ Bus Fare ______ other (please specify below) Please tell us about yourself and respond to the following questions: Why are you interested in attending this conference? How will attending benefit you and/or your community? You can write, record, or film you answers. Please turn this application in via email to: Or postal mail: WASILC PO Box 45343 Olympia, WA 98504 Signing below gives APRIL permission to use photos taken at conference in distribution materials related to APRIL. You also agree you understand that this is only an application and there is no guarantee you will be awarded a scholarship to attend the APRIL Youth Conference. You consent to being contacted by WASILC regarding this application. You also give permission to have your information shared with Department of Services for the Blind, if applicable. Name: Date: Parent/Guardian Permission Form
Name: Date of Birth: Email: Address: Preferred Form Do You Require Accessible/ of Communication: Alternate Formats? Have You Ever Attended the APRIL Conference? Yes No Are you currently a student? __Yes No This event is being held on a school day; can you obtain an excused absence? __Yes ___ No If you are awarded the Conference Scholarship, your registration will be paid. If you require other funding (such as lodging, transportation, etc.) please indicate this need below. Your need will not disqualify you from being awarded the scholarship. _________ Lodging _________ Other Need (please specify below) _________ Travel to include: ______ Plane Ticket ______ Bus Fare ______ other (please specify below) Please tell us about yourself and respond to the following questions: Why are you interested in attending this conference? How will attending benefit you and/or your community? You can write, record, or film you answers. Please turn this application in via email to: Or postal mail: WASILC PO Box 45343 Olympia, WA 98504 Signing below gives APRIL permission to use photos taken at conference in distribution materials related to APRIL. You also agree you understand that this is only an application and there is no guarantee you will be awarded a scholarship to attend the APRIL Youth Conference. You consent to being contacted by WASILC regarding this application. You also give permission to have your information shared with Department of Services for the Blind, if applicable. Name: Date: Parent/Guardian Permission Form
Info%20Application%20WASILC%20APRIL%20Youth%20Scholarship.docx