14th Annual Family Leadership Conference Scholarship Information

Thank you for your interest in attending the 14th Annual Family Leadership Conference!

Scholarships are reserved for parents or caregivers of a child with a disability, special needs or at-risk for developmental delay and youth with disabilities.  You will need to submit your completed application to Parents Reaching Out no later than 2/1/2018.

You can submit your application online, via email, fax or regular mail.  All mail-in applications must be postmarked on or before the deadline. Once your application is received, it will be scored according to need and available resources. If you are selected, you will be notified no later than 3/1/2018.  Please note that there will be no childcare provided at the conference.

Since applying does not guarantee an award, we highly recommend that you begin requesting assistance from your School, Head Start, Special Education department, Tribal Education Departments and/or other resources.  We will be happy to provide you with a letter to assist you with the request.

 Scholarships will include the following:

  1. Conference Registration Fee
  2. Meals provided as part of the conference
  3. Conference Materials
  4. One standard hotel room for the duration of the conference if traveling more than 150 miles round trip.

Please utilize the form below to submit your application.

You may also download a copy of the Scholarship Application here and submit it using the instructions on the form.

If you have questions or need assistance, please call Andrea Leon at 505-247-0192 or by email at aleon@parentsreachingout.org

Scholarship Application


First Name

Last Name

Spouse First Name (if attending conference otherwise type NA)

Spouse Last Name

Telephone

Address

City

State

Zip

Email

Ethnicity

Language Preference

Other Language

I am a

Other

Child Name

D.O.B.

Child Name

D.O.B.

Has your child received Early Intervention Services (EI) Click here to learn more about EI. .*

If yes, what agency

Does your child have special needs, a disability, or is at risk? If "yes", specify below:

If "Yes", please specify:

Please list the total number of people you are including in your scholarship application (only list those who will be attending the conference:

Adults:

Children:

Please provide additional information about your child's condition.

Tell us about any challenges you have experienced in navigating early intervention, special education or health care.

What are you interested in learning at the conference?

Would you be interested in attending an introduction to the Leadership Academy? The Pre-Conference session will take place April 19, 2017 from 1pm-5pm. Click here for more information on the Academy.