Jackson Lewis Scholarship Application

Solving the Campus Sexual Assault & Dating Violence Puzzle: Jackson Lewis Scholarship Application

Thank you to Jackson Lewis for funding registrations for 5 participants! Applications are due by November 19th, with notifications made by November 26th. Please note, if you apply and do not receive the scholarship, we will offer you the early registration rate.

Name(Required)

First Last

Email(Required)

Have you attended the Puzzles conference before?(Required)

Yes

Other

Campus/Organization(Required)

Position/Title(Required)

City/State(Required)

Please explain why you would like to attend the Puzzles conference (200 words or less):(Required)

Please explain why you need financial assistance (200 words or less):(Required)

Please describe how attendance at Puzzles will benefit you and your campus/organization and community:(Required)

What else would you like to share with us?(Required)