transforming-care-450px.png

 

2017 TCC: Scholarship Application for HIV + Participants

Equitas Health's Institute for LGBTQ Health Equity is offering a limited number of scholarships to Ohioans Living with HIV to attend the 2017 Transforming Care Conference. Scholarships include travel reimbursement, hotel accommodations, meals and conference registration. Please complete the application below to be considered for a scholarship. Scholarship recipients will be notified on or before October 6th, 2017.

  Tell us a little about yourself:

*

Name:

 

 

 

     

*

*

*

City/State/ZIP:

 

    

*

*

Date of Birth:

 

 


*


*


*


*
Question - Required - Racial Group(s)

*


*


*

*

*

   Please leave this field empty

     

© 2016 Equitas Health
4400 N High St, Suite 300, Columbus, OH 43214

(614) 929-8894
transformingcare@equitashealth.com