Student Scholarship Application

    

Please fill out the form below carefully. Your information will be used to assess you based upon a CI committee reviewing all applicants. This cycle for the scholarship has a deadline of December 15, 2010 for a start date of January 1, 2011. The award(s) will be posted by December 28, 2010. The scholarship is for all seven courses, excluding the books, and is contingent upon satisfactory performance in each course. Thank you for your interest. Please make sure your telephone number and email address are correct.

Congratulations to Russell Reichmann, recipient of the scholarship for October.
First Name
Middle Name
Last Name
Email Address
Telephone Number
Current Educational Level
State any professional work you have in the drug and alcohol counseling field.
In at least 150 words, describe what has led you to want to become a substance abuse counselor.
What will you do once you are certified?
What is your inspiration for wanting to become a substance abuse counselor?
Why do you want a scholarship?
Use this space for any additional comments you think would enhance your application.
 

 
     
 
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