NAPT 2010 CONFERENCE SCHOLARSHIP FORM

The National Association for Poetry Therapy Foundation offers scholarships to current NAPT individual members and other individuals who otherwise might not be able to attend the annual conference. Awards are based on financial need, contributions to the field of poetry therapy, and potential to give back to the field. NAPT members are given preference. Scholarships are awarded to cover part or all of the base conference fee and do not include pre- or post- conference workshops, room and board, or transportation.

Application Procedure: E-mail applications are preferred as a more sustainable option than mailing paper copies. Copy and paste the application below into Word as a new document, complete, and submit as an attachment. Send completed application to Paper applications may be mailed to Dottie Joslyn upon request. Scholarship forms will be accepted after Nov. 1, 2009, and deadline for receipt of the application is January 31st, 2010.

Scholarship applicants will be notified of our decision in February 2010.

1. Name: ______

2. Phone/fax: ______

3. Mailing Address: ______

4. E-Mail: ______

5. Are you a current member of NAPT ? ______

6. Are you interested in this conference as an introduction to NAPT? ______

7. Have you previously received a NAPT conference scholarship, and if so, which years?______

8. Are you a student? ______full time(12-15 hrs) ____ part time_____

9. Please describe your current or past NAPT activities and contributions:

10. Financial Need (Please list all figures in US dollars or equivalent):

A. Sources for funding for conference attendance:

Employer ______Out of pocket ______Other, please specify______

B. Assistance Needed (check all that apply):

___ Complete Registration Fee comp

___ Partial Registration Fee comp

___ With work exchange

___ Without work exchange

C. What else should we know about your Financial Situation?

Please Note: Although documentation is not required, more detailed information regarding finances with your application will assist us in making informed and balanced decisions. You may include copies of your most recent IRS or FAFSA statements.

11. Please write a statement, no longer than 500 words total, how your participation in the NAPT Annual Conference will benefit the field of poetry therapy, and what significance the conference would have for your personal and professional objectives.

Return Application to: . You will receive a reply e-mail to let you know your application has been received. Thank you.