2019 WI-AIMH Conference Scholarship Application
RequiredRequired Question(s)
WI-AIMH is very excited to be able to offer scholarships to support attendance at the 2019 Wisconsin Infant and Early Childhood Mental Health Conference!

Due to generous donations from funders, WI-AIMH is able to offer a limited number of scholarships to support professionals in attending this event. Scholarships will be awarded to cover partial registration ­­­costs. Scholarships do not provide funding for transportation or accommodations.

We currently have funding support for a variety of different types of scholarships, some of which have specific eligibility criteria. We also anticipate that a smaller number of general scholarships will be available.  
 
Our initial review of applications will be on July 10, 2019. Scholarships will be awarded beginning on July 15, 2019 following on a priority system based on the listed criteria. 
 
This event is being held on October 14-16, 2019 at the Osthoff Resort in Elkhart Lake, WI. Scholarship recipients will be responsible for their own transportation, travel costs, and any overnight accommodations. Expenses will not be reimbursed.

Questions? Contact kmagin@wiaimh.org 
 
Required 1.

Name:

 

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Required 2.

Street Address: 

 

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Required 3.

Email Address: 

 

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Required 4.

Phone Number: 

 

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Required 5.

Professional Title: 

 

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Required 6.

Organization:

 

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Required 7.
I am requesting:
Scholarship to attend the conference (October 14-15)
Scholarship to attend a post-conference Institute (October 16)
Our 2019 funding priorities for scholarship awards are:
1) To hear multiple voices by gathering together a diverse group of professionals.
2) To support professionals who face financial barrier to attendance.

Any information that you provide here will not be used or shared in any way outside of this application.
 
Required 8.

Which of the following apply to your application? (check all that apply) 

      I work... 

with families impacted by poverty
in a direct service position
in a Tribal community site
with families of children aged 0 to 3
with children who are at risk for removal from the home
in/with a Family Foundations home visiting program
in one of the following counties: Ashland, Bayfield, Barron, Buffalo, Burnett, Douglas, Dunn, Forest, Iron, Oneida, Pepin, Pierce, Price, Polk, Sawyer, St Croix, Vilas, Washburn
In Milwaukee County
with members of an under-represented group
with a multi-lingual population
with a very high need population not listed above. Please describe in Comments
  • Comment:

  • 500 characters left.
Required 9.

Which of the following apply to your application? (check all that apply) 

      I am... 

a person of color
someone with a first or home language other than English
a members of an under-represented group
taking unpaid time off to attend this conference
an early career professional (first 5 years)
new in a supervisory role (within 2 years)
a bi-lingual service provider
a child care provider
a first time WI-AIMH Conference attendee
not a recipient of a past WI-AIMH conference scholarship
isolated professionally
currently pursuing IMH-Endorsement
IMH-Endorsed
someone who would face a financial hardship to attend without scholarship support
in a unique circumstance not described above. Please describe in Comments.
  • Comment:

  • 500 characters left.
10.

Is there anything else that you'd like to share with us as we are reviewing your application? 

 

1000 characters left.
I have read and understand the requirements for scholarship recipients and by signing below I agree to adhere to these requirements. I agree to respond to any requests for information and to submit paperwork by established deadlines. I understand that failure to adhere to requirements and/or submit information will result in the loss of scholarship. If awarded a scholarship, I agree to either register for the event or to notify WI-AIMH that I will not be attending.
 
Required 11.

Please type your name to indicate your acknowledgement. 

 

50 characters left.