CJAM Financial Assistance Training Scholarship Application Form
The Community Justice & Mediation Center (CJAM) is committed to building a diverse and representative mediator pool and to offering affordable mediation training. If you live or work in Monroe County and need financial assistance to enable you to attend the training, please complete this application form. We have a limited amount of funds available. Once your application is reviewed we will contact you. If you have additional questions, please contact us at admin@cjamcenter.org

If you complete this form, you do not have to complete the training application form. Thanks for your interest!
First Name *
Last Name *
Email *
Address (Street,City,State,Zip) *
Phone Number *
D.O.B. *
Gender
Race
Employer and occupation (if student, please list school/major and indicate anticipated graduation date.)
How did you hear about this training? *
How long do you plan to be in the Bloomington area? *
Have you had previous conflict resolution training *
Required
If yes, please describe previous mediation.conflict resolution training.
For which training are you requesting financial assistance? *
Required
Reason for attending training: *
How will this training help you meet your personal/professional goals? *
We have a limited amount of scholarships available. How much can you contribute to the cost of this training? (Cost:$300) *
Are you interested in possibly volunteering with CJAM, once you complete the training? In addition to to mediator opporutnites we have other opportunites. *
Required
If yes, please indicate what kinds of work you might like to contribute: Mediation, Professional, Office, Marketing, Fundraising, and other skills.
Any additional comments:
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