LGBTQ+ Mental Health Summit 2023 – Scholarship Application

Thank you for your interest in this conference! We do not want cost to be a barrier to attending. Please answer the questions below and we will reveiw your request promptly. You will receive an email confirmation if your scholarship is approved, along with a promo code to waive your conference fee.

Your name and contact info

First Name *

Last Name *

Email (Primary) *

Phone (Primary) *

Scholarship application

Are you a member of the LGBTQ+ community? *

Yes No

Do you need financial assistance to attend this conference? *

Yes No

Check an attendance option: *

I would like to attend the conference AND see ALOK. I would like to attend JUST the conference.

Would you like to receive continuing education credits for attending? *

Yes No