Yes 2 Me Scholarship Application
SSA will be disbursing seven $2000 scholarships across Alberta to those living with schizophrenia.
Email address *
Sponsored by the Alliance of Otsuka and Lundbeck
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
Province *
Your answer
Postal Code *
Your answer
Phone Number *
Your answer
Age *
Your answer
Diagnosis *
Your answer
Name of reference (reference submission is required in order to be considered for the scholarship) *
Your answer
Email and/or Phone number of reference *
Your answer
Current level of education *
Required
Name of school where you are enrolled *
Your answer
Full mailing address of school (please include postal code) *
Your answer
Name of the program you are enrolled in - preference will be given to those who have completed one term or more of their program *
Your answer
Tuition Cost *
Your answer
Books *
Your answer
Other
Your answer
Please tell us about yourself and why you feel you should be chosen for the scholarship. 500 words minimum. *
Your answer
I authorize the release of my name and/or likeness to the media to be used by SSA and sponsors where legal, for publicity and promotional purposes. *
I agree to share information on my education to the Schizophrenia Society of Alberta and sponsors to be shared in the Yes 2 Me Celebration event, social media and other marketing materials and advertisements. *
Required
Sponsored by the Alliance of Otsuka and Lundbeck.
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