When should I apply? Scholarship applications will be accepted any time and will be placed in order by the date of the application process. Those who have been accepted for the scholarship process and who apply first will have first access to services. You will be contacted via e-mail to keep you posted on your progress in getting a placement for services, including information regarding if you have been placed on a waiting list for services.
Please complete all information to the best of your ability and submit all requested documentation via e-mail if you have access to the internet.
Please include all the following information when contacting me:
Name
Contact information:
Mailing Address:
Phone number:
E-mail address (if you have access to the internet)
Please list all previous therapy you have received: name of business, type of service you received there, type of professionals who worked with you while you were there, when the service occurred, on a 1-10 scale indicate the helpfulness of the services (1 not helpful 10 Extremely helpful), on a 1-10 scale indicate your readiness for using the services at the time they were offered to you (1 not ready- I HAD to go to treatment 10- I worked really hard during this time). Also indicate the approximate length of time you used each service.
Please list any hospital stays related to mental health concerns—where were services received, when were you there, how long were you inpatient?
List any mental health diagnoses you have been given by past professionals.
Report any current or past suicidal thoughts, plans or attempts. Report any struggle with harming others.
Please share some information with me about your current financial situation/work status/academic status/ goals for yourself professionally.
List any medications you take and who monitors those medications for you.
List any other groups/services you are currently using as recovery tools.
Please describe for me a typical day in your current life- what parts are going well? What things are you struggling with? Be sure to include a description of your mood; any negative coping behaviors you use—self harm; food manipulation; substances; share with me information about the important relationships in your life. It is essential for you to share with me any thoughts about suicide or harm to others you are currently experiencing.
Please tell me why you feel that right now is a good time for you to utilize this scholarship offer?
Please detail how you will “pay it forward”. What service will you offer? Who/what organization will benefit from this service/talent?
Please be sure to include any other information you feel is important for me to know when making the decision about your scholarship application.
Make sure to complete the scholarship chart and send it back with your writing. Be sure to follow up with your letter writers and verify they sent their recommendations to me.
Feel free to include any drawing/journal entry you feel demonstrates any of the above information.
Please remember that as with all scholarship applications, there is no guarantee that you will receive a scholarship for services. This is simply the application process. If you have not heard back from me within a week of e-mailing your scholarship application to me, please phone me: 515-231-3918.
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