South Texas Adolescent Health Summit Scholarship Request
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The South Texas Adolescent Health Summit, August 28-29, 2018, will bring together 180 youth-serving professionals from South Texas and the Coastal Bend areas to participate in two days of networking, expert discussions, and presentations with a focus on positive youth development and improving adolescent health. 

Registration cost is $50 for the two-day event and attendees will be responsible for travel and hotel costs, if needed. 

A limited number of scholarships are available for the summit registration fee. Please indicate if you are interested in applying for a scholarship and answer any of the related questions.
 
Required 1.
Please enter the information indicated below.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
City:
State/Province
(US/Canada):
Institution/Company:

Required 2.
Are you or your organization able to cover a portion of the $50 registration cost?

If so, please note how much you can cover in the comment section.  
Yes
No
  • Comment:

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3.

How would you and/or your organization benefit from receiving a scholarship?

 

1000 characters left.