Conference Scholarship Application

A limited number of scholarships are available. Application deadline is February 25, 2019. You will be notified of award by March 1, 2019, and then be able to register via a special scholarship code. Scholarship funding made possible by the Oregon Health Authority, Health Services Division and the Oregon Alliance to Prevent Suicide.

Name*
First Last
Profession*
Organization
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
How will the OSP conference help your work in your community, workplace, or school?*
Are you a CSAC or Oregon Alliance to Prevent Suicide member?
Please indicate below
- OHA Children’s Systems Advisory Committee (CSAC)
- Oregon Alliance to Prevent Suicide
Name
This field is for validation purposes and should be left unchanged.