2021 Conference Scholarship Application

If you need assistance attending the virtual conference, please fill out the form below.

Scholarships are for Pennsylvania residents only.

Deadline in March 1st, 2021

Name of Applicant (required)

Name of Organization (if applicable):

Address (required)

County (required)

Phone (required)

Your Email (required)

Website

List any permits you possess: (if applicable):

List any permits you will be applying for: (if applicable):

Are you a 501(c)(3)?:

If you are not permitted, please list any wildlife rehabilitator/center where you have volunteered:

Contact person at that facility:

Contact person's phone:

Contact person's email:

Have you previously applied for a scholarship from the Pennsylvania Wildlife Rehabilitation and Education Council?

Please give a brief explanation as to why you need assistance in attending the conference: