2019 Pay-It-Forward Scholarship Application
Presented by The New England Region of the American Music Therapy Association's Membership Support Comittee

Applications are due by December 9, 2018 at 11:59 PM with decisions going out by December 18, 2018. Recipients must make their partial payments for membership by January 30, 2019.

If you have any further questions, please contact committee chair at membershipsupport@musictherapynewengland.org

Email address *
NAME: *
Your answer
Additional Credentials
Your answer
Where do you live in the New England region? *
MUSIC THERAPY CREDENTIALS: *
Have you ever been an AMTA member in the past? *
If yes, how many years ago?
Your answer
What is your current employment status? *
How many hours a week are you working as a music therapist?
Your answer
Please check the amount YOU are able to contribute towards the cost of your membership. *
The full cost of professional membership is $250.
Do you have coupons from your internship packet that you can use for your first or second year of membership? *
If you do not have a Welcome to the Profession Intern Packet from AMTA, you can request one here: http://www.musictherapy.org/careers/packets/
If so, what is the amount of your coupon?
Your answer
How can you pay your membership forward in a non-financial way? *
Please check two ways to "Pay it Forward".
Required
Please identify one person to whom the Committee can contact as a personal or professional reference. Include the person's: 1) Name 2) Email address 3) Telephone number. *
Your answer
PERSONAL STATEMENT SECTION
PAY IT FORWARD NARRATIVE SECTION
Please write in paragraph form.
Why do you want to be a member of the NER and AMTA? *
Your answer
What do you want to get out of being a member? *
Your answer
How will being a member impact your professional life or your work in the field? *
Your answer
Is there anything else you would like mention? *
Your answer
The Committee asks that each award recipient complete their pay-it-forward task(s) and submit a short summary by December 15, 2019. These short summaries are to be emailed to the Membership Support Committee at: membershipsupport@musictherapynewengland.org. This will help us gather feedback, add new ideas to how other MT-BCs can Pay It Forward in future years, and support the continuation of this new program. Do you agree to this? *
Required
Names of recipients of Pay It Forward grants must be shared with AMTA in NER’s annual 990 report for tax purposes. Do you agree to this? *
Required
NER-AMTA cannot guarantee anonymity after the blind review process is complete and grant decisions are finalized. Do you agree to this? *
Required
A copy of your responses will be emailed to the address you provided.
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