Academic Scholarship Application | EQmmunity Impact Fund

Academic & Non-profit Scholarship Application

Please take a moment to fill out the form.

Applicant Information

First Name

Last Name

Street Address

Street Address Line 2

City

State

Postal / Zip code

Phone

What is your birthdate? required

Academic Institution / Non-profit Name

Please descibe Your Position and Role in the Organization

Did someone refer you to the ChoiceCenter trainings?

Yes

If yes, who referred you? (Share their name & relationship to you.)

Are you requesting support for a full or partial scholarshp?

Full scholarship

50% Scholarship

Either Full or Partial

About Your Organization

Tell us about your organization

How many years have you worked for the organization?

Should you receive support, describe the impact developing your emotional intelligence (EQ) and leadership skills will have on your organization and its outcomes.

Optional Info

If there is anything additional you would like to share with us, please share it in the field below. Please note that choosing not to provide additional info will not impact your application. Thank you for your application.

What did your military service teach you about leadership, resilience, and teamwork? How do you apply those lessons today?