MiCHWA Scholarship Application

With funding from generous partners and allies, MiCHWA is able to offer CHW scholarships and partial scholarships to events and MiCHWA-certified training programs. MiCHWA-certified CHWs interested in participating in these activities are encouraged to apply for a scholarship. Funding will support members’ attendance at the preferred event or training.

The scholarship honors the important work of CHWs who promote public health in their communities. We want to support your commitment to the CHW Workforce.
Sign in to Google to save your progress. Learn more
Scholarship Options: *
Required
Full Name *
Email *
Phone *
Organization *
Employer County *
Job Title *
Describe how your organization contributes to improving community health. *
What role do you play in the organization and how does it affect your community? *
How long have you worked/volunteered in this program as a community health worker? *
Please describe your participation in one of MiCHWA’s work groups and how it strengthens the CHW field. Work groups: 1) Michigan CHW Network, 2) Communications, 3) Education & Workforce, or 4) Policy & Finance or indicate if you do not participate. *
Please describe a volunteer (non-paid) experience that benefitted the health of individuals in your community or indicate if you are not a volunteer. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Michigan Community Health Worker Alliance (MiCHWA). Report Abuse