Screen Shot 2018-04-03 at 12.15.56 PM.png

Symposium Scholarship Application

Name *

Name

First Name

Last Name

Email Address *

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization or School Affiliation *

Statement of Purpose: Please describe, in approximately 500 words, your current arts in health work. Explain how the symposium would assist you in meeting goals for this work, and outline ways in which you will be able to contribute to the general dialogue and discourse at the conference. *

Scholarship recipients must volunteer during a portion of the event, please indicate your interests or skills. *

Select all that apply

Check in Table: 10 am - 2 pm, May 1

Check in Table: 8 am - 12 pm, May 2

Photo/Video/Social Media

Technical Support

Will you need housing on May 1? *

Yes

Scholarship Application

Symposium Scholarship Application

Arts for Health Florida