Application form NAMI 2012

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Mental Health Services (CMHS), through a contract with Westover Consultants, Inc. (Westover), and AFYA, Inc. (AFYA), is providing financial support to consumers of mental health services who wish to participate in the 2012 National Convention sponsored by National Alliance on Mental Illness (NAMI).  SAMHSA reserves the right to cancel scholarships at any time.  The purpose of this scholarship is to foster the transformation of mental health care to focus on recovery.  Please Note:  To be eligible for this scholarship, a completed application must be received by U.S. Mail, postmarked on or before the deadline of March 12, 2012.  NO FAXED OR E-MAILED SUBISSIONS WILL BE ACCEPTED. 

Scholarship Conditions 

Please note that to be eligible for this scholarship, you must be a U.S. citizen and a mental health consumer.  If you are selected as a scholarship recipient, a representative from AFYA will contact you via e-mail and/or mail by April 16, 2012, to discuss logistical arrangements.  Scholarships cover the conference registration fee, hotel expenses (based on double occupancy), ground transportation, airfare, and per diem (daily allowance for meals and incidental expenses).  In order to provide as many scholarships as possible, we ask that you be willing to share a room with another scholarship recipient. 

As a scholarship recipient, you will be asked to do the following: 

1. Submit a 2 to 5 page report to AFYA, in a format provided, within 2 weeks of the conclusion of the conference.  Your report will be summarized and shared with CMHS, other scholarship recipients, the sponsoring conference organization, and others.
2. Submit a completed evaluation form within 2 weeks of the conclusion of the conference.  The form will be provided.
3. Submit a completed travel reimbursement form within 2 weeks of the conclusion of the conference.
4. Share a room with another person during the conference.
5. Agree to have your name and contact information shared with other scholarship recipients.  If you would like to keep your contact information confidential, please contact the scholarship conference manager.
6. Inform the scholarship conference manager, as soon as possible, if you are unable to attend the conference or will be delayed in meeting any of the above conditions. 

Conference information is available at www.nami.org/convention.