Scholarship Application for Food As Medicine 2008

We welcome your application for scholarship assistance.

We have special scholarships for Baltimore healthcare professionals and community educators working with underserved populations. We also have a limited number of partial scholarships available for health professionals working with underserved communities in other areas of the country and world. Please provide the following information, noting n/a if necesary in required fields*.

* - These fields are required
*First Name:
Middle Name:
*Last Name:
*Degrees:
Profession:
(Hold 'Ctrl' button to select multiple)
*Title:
*Company / Institution:
*Address1:
Address2:
*City:
*State *Zip
Country if other than the U.S.:
Please provide at least one preferred phone number:
Work Phone:
Home Phone:
Cell Phone:
*Email:
*Are you currently working with underserved communities? Yes      No
 
*Briefly describe your work in the space provided:

Please Note:

  • Tuition includes breakfast and lunch daily, and a gala opening dinner. All other meals are your responsibility.
  • Travel costs and accommodations are your responsibility, but we are happy to find you a roommate to cut the accommodation cost in half.
  • All participants are required to attend the training in its entirety.
  • Unfortunately, we are unable to provide scholarships to students as the student tuition is as low as possible.
  • Please note that filling out this application does not guarantee you will be awarded scholarship.

The Center is committed to helping those who otherwise could not attend our trainings with partial scholarships. We believe that if everyone pays what they are able then we can assist the greatest number of people in attending our trainings. Please note how much you can afford to pay.
*I can afford to pay $

Yes, I am interested in having a roommate