The Diana Initiative Student Scholarship Application
We are collecting donations in order to offer a scholarship to students to be able to attend The Diana Initiative (TDI) 2019.

Read more about The Diana Initiative information security conference here: https://www.dianainitiative.org/

We will award a number of recipients based on the number of donations we receive. We will not be able to award everyone a scholarship and will inform everyone by email if you have been accepted or not as soon as possible.

Please use the form below to apply for a scholarship.

If you wish to donate to the scholarship please go here: (link)

Email address *
Scholarship Details
Student Scholarships include:

1) An entry badge for The Diana Initiative 2019

2) Hotel accommodations (arranged by TDI).

You are responsible for any incidentals and will need a credit card or debit card at check-in.

You will need to be 21 years old or older to check in to the hotel. If you are less than 21 years of age a person age 21 or older will need to check-in and stay in the hotel room with you.

Your legal name (first and last) *
Your answer
Please let us know your preferred pronouns *
Your answer
What name or nickname do you prefer to be called? *
Your answer
Please tell us a little bit about yourself and why you are interested in information security. *
Your answer
Please tell us how what you learn at TDI will benefit you, and what you will be able to do with that when you get back home. *
Your answer
Your origin location *
Country and area, please do NOT include your actual address. For example: Philadelphia area of Pennsylvania USA or Calgary area of Alberta Canada
Your answer
What type of student are you? *
High School, College, etc.
Your answer
My age is *
Is there anything else that you would like to share?
Your answer
Please read the conditions
If chosen as a scholarship recipient you will be required to fill out a W9 or similar tax form as required for our taxes. You agree that you are responsible for filing your own taxes related to the scholarship. We will provide a receipt for the value of the room and the ticket to the conference.

You agree that you can attend TDI August 9 & 10, 2019 in Las Vegas, NV, USA

You agree that you are responsible for your own travel to and from the event.

You agree that you are responsible for your own food during the event.

You are responsible for any incidentals at the hotel and will need a credit card or debit card at check in.

If you are under 18 you will provide your legal guardians' contact information and they will be required to agree to all the conditions and in addition, agree that they will accompany you and be responsible for you. We will provide them an entry ticket, and there will be no additional funds or benefits provided. You will both be expected to share the hotel room.

If you are under 21 you will need someone 21 or older in order to be able to check into the hotel. You will need to provide their contact information and they will be required to agree to all the above. We will provide them an entry ticket, and there will be no additional funds or benefits provided. You will both be expected to share the hotel room.

I agree to the conditions above *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service