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CFRI's CF Summer Retreat Scholarship Application

Scholarships are offered to those who could not otherwise attend this event. Unless this applies to you, please allow those who really need the scholarship to receive this support. Preference will be given to individuals with cystic fibrosis.

Please submit your request for scholarship by July 21, 2017. Your application will be reviewed by a small committee and your information will remain confidential. We will contact you to inform you if a full or partial scholarship will be granted to you.

If you have any questions, please contact Mary at 650.665.7559 or cfri@cfri.org. Thank you!



City, State, Zip:


Email:


Phone:
               

Relationship to CF:
CF Adult
Family Member
Parent/Gardian for teen <18
Volunteer
Other:


What dates will you be arriving and leaving the retreat?

Arriving:  Leaving:

How many nights will you be staying at Vallombrosa?


How many days will you be attending?


What kind of scholarship are you requesting?

Full scholarship to cover registration fee.
Partial scholarship to cover registration fee.
Full scholarship to cover overnight accomodations (room and board).
Partial scholarship to cover overnight accomodations (room and board).
Full scholarship to cover travel.
Partial scholarship to cover travel.

If you are applying for a scholarship to cover travel, how much would be the cost?



Have you attended the retreat before?




Have you previously received a scholarship from CFRI?




What is your reason for requesting a scholarship?




How will participating in this year's retreat benefit you?




How did you hear about retreat?



Please describe your source of income:




Please select your financial situation:











Check one:





Are you also planning to attend CFRI's Education Conference?

Yes No


Enter your initials if you agree:

I have read and completed all the sections of the above application and the information provided is correct.

After you submit this application, you will be redirected to the registration page.

Thank you!


SUBMIT


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