Michael K. Falligant Scholarship Application
2023 Application Cycle
This scholarship is awarded by the Crisis Center Junior Board on an annual basis.
Responses are due by
Friday, September 1, 2023.
*
1.
Email
(Required.)
*
2.
Name
(Required.)
*
3.
Age
(Required.)
*
4.
Pronouns
(Required.)
*
5.
Phone
(Required.)
*
6.
Position at the Crisis Center
(Required.)
*
7.
Volunteer or Staff?
(Required.)
Volunteer
Paid Staff
Other
*
8.
What is your total length of service at the Crisis Center?
(Required.)
*
9.
What is the highest level of education you have completed? (Institution and Year)
(Required.)
*
10.
Are you currently enrolled or do you have plans to enroll in any education program?
(Required.)
Yes
No
Other (please specify)
*
11.
If yes, please list school or university you are attending or plan to attend.
(Required.)
*
12.
What degree program are you pursuing?
(Required.)
*
13.
Expected graduation date
(Required.)
*
14.
Do you wish to apply for scholarship for this education?
(Required.)
Yes
No
Other (please specify)
*
15.
How would a scholarship help you achieve your goals?
(Required.)
*
16.
Describe the work you do at the Crisis center?
(Required.)
*
17.
What prompted your involvement with the Crisis Center?
(Required.)
*
18.
What is the most meaningful part of your work? Do you have any examples?
(Required.)
*
19.
What's your favorite thing about working at the Crisis Center?
(Required.)
Please provide this
recommendation form
to your references. Recommendations are due by
June 1, 2022
.
