Save the EPA
This is the scholarship application and the registration form. The scholarship includes lodging and travel to and from the host city. If you have any questions please email payton.wilkins@cbtu.org
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
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Email Address *
Your answer
Phone Number *
Your answer
Home Address *
Please include: Street address, City, State, and Zip Code
Your answer
What do you do? *
Tell us about yourself. Please include information like occupation, student status, and/or retiree. Let us know what type of activism work you do, or have done.
Your answer
Why do you want to save the EPA? *
We would like to know that you're serious about joining us at this conference. Please provide insight into your motivation for participating.
Your answer
How do you think we can save the EPA? *
Your answer
What do you think is the EPA's greatest threat(s)? *
Your answer
Are you applying for a scholarship? *
Including travel, lodging, and all the other nuts and bolts it takes to pull this conference together it cost about $1,000 per participant. Are you able to contribute anything to defer cost for your participation? It's important to note that your response to this answer has no bearing on your application being selected for scholarship. In other words, it doesn't matter if you can't, but if you can it will help others attend. *
If so, how much?
Your answer
Is there anything else you want us to know?
Your answer
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