11th Annual Mental Health and Substance Use Recovery Training Conference
October 21-22, 2015, Kalahari Resort & Convention Center
Scholarship Application: for people in mental health and substance use recovery
To apply, complete the information requested below, include a $10 application fee, to be paid by cash or check
(payable to UW-Stevens Point), and mail it so that we receive it no later than September 25, 2015.
Remember: DO NOT REGISTER for the conference if you are submitting a scholarship
application. If you are awarded a scholarship, instructions will be sent in an email with
specific scholarship registration information by September 28th. If you are NOT awarded a
scholarship, your $10 application fee will be returned or applied towards your full conference
registration if you choose to do that.
Mail to:
UWSP Continuing Education
2100 Main Street, 032 Main Building
Stevens Point, WI 54481
Scholarship notifications will be made beginning September 28, 2015. If you apply but do not receive a
scholarship, we will honor the early registration fee of $190 if you still wish to attend. Scholarships are nontransferrable.
Name: _______________________________________________________________________
Address: _____________________________________________________________________
City, State, Zip: _______________________________________________________________
Telephone: ___________________________________________________________________
E-Mail: ______________________________________________________________________
Are you a person in mental health and substance use recovery?
Are you a Certified Peer Specialist
Funding requested:
one night’s lodging (must reside at least 50 miles from Conference location)
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Complete information on both pages
Please answer the following questions (attach a separate piece of paper if needed):
1. Why do you wish to attend the conference?
2. How will you share the information obtained at this conference with local or statewide consumer
groups?
3. What are the specific issues across the lifespan, related to mental health/substance use recovery, in
which you are most interested?
4. Are you currently involved in any programs or activities in the mental health/substance use recovery
By accepting this scholarship, I agree to help with staffing needs at the conference, and to utilize and share this
knowledge with my peers and others.
_________________________________
Applicant Signature
________________
Date
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Complete information on both pages