ClexaCon 2019: Scholarship Application
You are applying for a scholarship to help you get to ClexaCon 2019 in Las Vegas.
First Name: *
Your answer
Last Name: *
Your answer
Email Address: *
Your answer
Phone: *
Your answer
Location: *
Where would you be traveling from?
Your answer
Airport Code:
Please list your airport choice if applying for flight assistance.
Your answer
Twitter Handle:
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Other Social Media Links:
For example: @ClexaConvention on Facebook / clexacon on Tumblr
Your answer
Your Age: *
Please enter your age as of ClexaCon 2019 (April 11, 2019)
Your answer
Gender: *
Required
Race/Ethnicity: *
Applying as: *
Do you need financial assistance for flights? *
Do you need financial assistance for your hotel stay? *
Are you applying for financial assistance for a 3-day pass? *
Write your essay (350 words max): *
Please write your essay with a maximum of 350 words
Your answer
I acknowledge if I am selected, my name and photo will be listed in the program/app/ClexaCon website as a scholarship recipient. *
Required
I agree to the Terms and Conditions *
Please see our Terms and Conditions listed here: https://clexa-con.com/terms/
Required
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