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2023 Convention Scholarship Form
We have limited scholarships available for people with disabilities and families
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* Indicates required question
Email
*
Your email
Your First Name
*
Your answer
Your Last Name
*
Your answer
Street Address
*
Your answer
City/Town
*
Your answer
State
*
Your answer
Zip
*
Your answer
Phone number with area code
*
Your answer
About You
*
I am a person with a developmental disability
I am a family member
What age is the person with a disability?
*
0 - 2
3 - 5
6 - 18
Adult
Required
What type of Scholarship are you applying for?
*We have very limited funding to help with hotels.
*
Registration Only
Hotel Only
Registration & Hotel
Why are you requesting a scholarship?
*
Your answer
If you only receive a Partial Scholarship, what is the maximum you can pay?
*
Your answer
The Arc of Virginia will contact you to let you know if you receive a scholarship or to disucss further. Thank you!
A copy of your responses will be emailed to the address you provided.
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