Scholarship Request--Racial Justice Summit 2020

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The questions below allow us to make selections for scholarships according to YWCA Madison's Scholarship Policy and our Mission of Eliminating Racism and Empowering Women.

Please fill out the form below to be considered for a scholarship to attend YWCA Madison's Racial Justice Summit on September 29, 30 & October 1, 2020.

PLEASE NOTE: The first round of selections for scholarships is open.
***You will be notified if you have been selected to receive a scholarship by September 30th, 2019.***
You will also be provided with registration information at that time.

Email *

First Name *

Last Name *

Race *

Black, Afro-Caribbean, African or African American

East Asian or Asian American

Middle Eastern, North African (Sub-Saharan) or Arab American

Multi-Racial

Native American or Alaskan Native

Native Hawaiian or Pacific Islander

South Asian or Indian American

White or Euro-American

None of the Above: See Below for my Race

Your Racial Identity Information, if not selected above:

Gender Pronouns:

If you would like to be considered for a scholarship, please check all of the following criteria that apply to you: *

I am unemployed, or have a low income: without a scholarship, I would be unable to attend.

I am connected to the YWCA as a service recipient.

I have not received a scholarship to attend a YWCA event within the last calendar year.

Required

(If Applicable) Organization or Group Affiliation

If you would like to, please include any additional information you would like us to know as we consider your request for a scholarship here:

Limited Scholarships are available. If we have reached our scholarship capacity, you have the option to be put on a wait list for scholarship consideration. Please indicate below if you would like to be added to a wait list if we have reached capacity.

Yes, if you have reached scholarship capacity, please add me to your wait list.

No, no need to add me to the scholarship wait list.

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