Scholarship Aid Request

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The Association for Nature-Based Education (ANBE, formerly known as ERAFANS) uses the following information to help establish need for scholarship aid. This information is confidential and is not shared with third parties. Applications are reviewed quarterly and funding is awarded on a first come, first serve basis. We want to help as many teachers as we can, but demand is high and funding is limited. See complete eligibility details at www.anbe.org/scholarship.

Email *

Have you received aid to attend an ANBE (formerly ERAFANS) program within the last two (2) years? *

Yes

Have you received aid to attend an ANBE (formerly ERAFANS) program within the last year? If yes, you do not meet the requirements to receive aid again this year. *

Yes

Has someone at your school or organization received aid to attend an ANBE (formerly ERAFANS) program within the last year? If you are unsure, please ask your administrator before responding. If yes, you do not meet the requirements to receive aid. *

Yes

Name (first, last) *

Street address *

City *

State *

Zip code *

Phone number *

Which categories describe you?

Indigenous, First Nations, or Alaska Native (for example: Navajo Nation, Mohawk, Cheyanne, Susquehannock)

Asian (for example: Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese)

Black or African American (for example: Jamaican, Haitian, Nigerian, Ethiopian, Somolian)

Hispanic, Latino, or Spanish origin (for example: Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran, Dominican, Columbian)

Middle Eastern or North African (for example: Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian)

Native Hawaiian or other Pacific Islander (for example: Native Hawaiian, Samoan, Chamorro, Fijan, Marshallese) Tongan,

White (for example: German, Irish, English, Italian, Polish, French)

Some other race, ethnicity, or origin. Please specify:

Prefer not to say.

How do you describe your current employment status? (Check all that apply.) *

Employed full-time (35 or more hours/week)

Employed part-time (less than 35 hours/week)

Self-employed

Unemployed or on furlough

Retired

Student

Other

Required

Current employer (school or organization name) *

Do you work in a Title 1 School or School District? (See Title 1 definition here: https://nces.ed.gov/fastfacts/display.asp?id=158). *

Yes

Age of children you teach *

Total number of children you teach each year *

What is your annual salary? *

If not on salary, what is your hourly rate? And how many hours per week do you work? *

What is your annual household income range? *

up to $20,000

$20,001 - $40,000

$40,000 - $60,000

$60,001 - $80,000

$80,001 or more

Is there anything else we should know about your financial situation that relates to why you are requesting scholarship? Please describe. *

What is the highest level of education you have completed? *

Highschool diploma

Two-year degree or junior college

Undergraduate degree

Masters degree

PhD

Other:

What is your major or field of study? If completed, what was your degree in? *

List any other specialized training or awards you have received. *

What is the title of the last professional training you attended? *

How did you finance attendance to the training previously described? (choose all that apply). *

Paid for it myself

My employer paid

I recieved scholarhip aid or financial assistance

It was free

Other:

Required

List the name and email address of a professional reference (supervisor): *

List the name and email address of a professional reference (colleague or professor): *

For which training or professional development course are you requesting aid? Include title and up-coming date of training. *

If selected, will you be available to attend the entire training or course you are applying for? *

Yes

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