Scholarship Application Please use this form to apply for a scholarship at a workshop. Name * First Name Last Name Email * Name of organisation/private practice * Profession * Scholarship Criteria I want to apply for a * Full scholarship Part scholarship Using the criteria outlined on the scholarship page, please tell me why you would like to apply for a scholarship and why you should be awarded one. Comment on criteria areas of: (1) Relevance (2) Need (3) Impact (4) Commitment T&Cs I agree to have my name and profession used in marketing by NeuroDiversity Affirming Training & Supervision * Yes No I agree to share at least one social media post on my own socials to promote the workshop * Yes No I agree to provide to write a testimonial about the training which can be used as marketing materials. * Yes No I am able to commit to attending the workshop. * Yes No Thank you for your application. We will be in touch regarding the outcome.
