2006 NCDD Conference Scholarship Application
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| If you (or your organization) are unable to cover the entire registration fee, lodging costs and/or travel costs associated with attending the conference, please submit this application as soon as you are able to. Please only apply for the assistance you need so that we can support as many people as possible with our limited scholarship funds. |
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| Contact Information |
| Name: |
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| Organization or School: |
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| Your Title or Position: |
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| Email Address: |
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| Daytime Phone: |
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| Mailing Address: |
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| Demographic Information |
| Our scholarships will, in part, help us ensure that participants at the conference are as diverse as possible ?– in age, race, political ideology, and level and type of experience. Responses to the following questions are required for scholarship applications to be considered. |
| What is your age? |
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??under 18?? ??18-25?? ??26-35?? ??36-45?? ??46-55?? ??56-65?? ??over 65 |
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| What is your race/ethnicity? (Latino, white, etc.) |
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| How many years of experience do you have in dialogue and/or deliberation? |
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| Please briefly describe your involvement or interest in dialogue and deliberation. |
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| Why are you interested in attending the 2006 National Conference on Dialogue & Deliberation? What would you hope to get out of your participation in the conference? |
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| Additional Details (optional): |
| Are there other ways in which your involvement in the conference would help us meet our goals for diversity? Specifically, we would like to involve more LGBT people, young people, political conservatives, people of color, and people from outside of the U.S. in this year?’s NCDD conference. |
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| Is there a particular reason you are in need of a scholarship this year? Let us know, for example, if you are a full-time undergraduate student, a victim of Katrina, etc. |
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Level of Support Sought
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| Please indicate which of the following you are seeking financial support for. Note that because our scholarship funds are limited and many people need support, we are able to grant very few (if any) full scholarships. |
| Conference Registration Fee |
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??I am able to pay $200 - partial discount for conference registration fee. |
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??I am able to pay $100 - deep discount for conference registration fee. |
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??Need full discount for conference registration fee. |
| Pre-Conference Training Fee |
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??I am able to pay $50 - partial discount for pre-conference training fee. |
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??I need full discount for pre-conference training fee. |
| Lodging |
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??I am willing to share a hotel room with another conference participant. |
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??I would prefer to have a hotel room to myself. |
| Transportation |
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??I would appreciate $250 towards my transportation costs. |
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| We will let you know via email as soon as we are able to what level of financial assistance we can provide you. We are thrilled that you are interested in attending the 2006 National Conference on Dialogue & Deliberation, and we hope to see you in San Francisco in August! |
| Preview your responses before submission. |
| Review your submission: |
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