{"id":2028,"date":"2023-07-23T13:03:13","date_gmt":"2023-07-23T17:03:13","guid":{"rendered":"https:\/\/ksha.info\/?page_id=2028"},"modified":"2025-10-17T12:36:29","modified_gmt":"2025-10-17T16:36:29","slug":"dei-scholarship-application-form","status":"publish","type":"page","link":"https:\/\/ksha.info\/index.php\/dei-scholarship-application-form\/","title":{"rendered":"DEI Scholarship Application Form"},"content":{"rendered":"<h3><strong>RISE Scholarship Deadline: January 15<\/strong><\/h3>\n<p><strong>Application and Supporting Documents Deadline:<\/strong> Forms must be submitted electronically, using the online form below or via email by January 15.<\/p>\n<p><strong>The minimum criteria to apply for KSHA\u2019s Diversity, Equity, Inclusion Scholarship are:<\/strong><\/p>\n<ul>\n<li>Evidence of academic achievement at the doctoral, graduate and\/or undergraduate level.<\/li>\n<li>Transcript showing current GPA (no minimum required) and enrollment in a speech\u2010language pathology or audiology training program.<\/li>\n<li>KSHA membership.<\/li>\n<li>Demonstrated service or commitment to diversity, equity, and inclusion through service and organizational participation<\/li>\n<li>Essay and Resume<\/li>\n<li>Letters of Recommendation.<\/li>\n<\/ul>\n<p><strong>Award recipient agrees to: <\/strong>Write an article for the KSHA Communicator describing how the award was used and what it meant to them to win.<\/p>\n<p><strong>The documentation listed below must be submitted together and received via electronic submission or mail no later than January 15:<\/strong><\/p>\n<ul>\n<li>Completed application &#8211; Printable document or online submission available below.<\/li>\n<li>Transcript to validate your GPA and program enrollment. While there is no minimum GPA required for this application, the GPA will be considered in the selection process.<\/li>\n<li>Current r\u00e9sum\u00e9 showing your academic achievement, employment history and relevant activities the doctoral, graduate and\/or undergraduate level.<\/li>\n<li>A typewritten 250\u2010500 word essay that includes:\n<ul>\n<li>Future plans and goals as a Speech\u2010Language Pathologist or Audiologist<\/li>\n<li>Discuss how your experiences related to aspects of diversity, equity, and inclusion can contribute to enhancing the field of communication sciences and disorders. These experiences may be personal, academic and clinical, and\/or community based<\/li>\n<\/ul>\n<\/li>\n<li>Letters of Recommendation from two of your program faculty written on your school\u2019s letterhead. The recommenders should address your financial situation, your ability to complete a graduate program and\/or conduct research, or other information relevant to your application.<\/li>\n<\/ul>\n<p>Note: The scholarship is typically valued at $2,000 each but is subject to change due to budgetary limits. A recipient may reapply in a future year.<\/p>\n<div class=\"divider-dot\"><\/div>\n<p><strong>Option 1: Printable Application Form<\/strong><br \/>\n<strong><a href=\"https:\/\/www.ksha.info\/pdf\/DEI-PrintableApplication.pdf\" target=\"_blank\" rel=\"noopener\">Printable Application<\/a><\/strong><br \/>\n<strong>Please address questions to: <a href=\"mailto:ksha.scholarships@ksha.info\">ksha.scholarships@ksha.info<\/a> or 800\u2010837\u20102446.<\/strong><\/p>\n<div class=\"divider-dot\"><\/div>\n<p><strong>Option 2: Online Application Form<\/strong><\/p>\n<p>Use the following online form. Please note when using the online form, you will also need to upload all of the supporting documentation at the same time as submitting the form.<\/p>\n<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-11\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">If you are human, leave this field blank.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-11\" value=\"1789143466\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"11\" id=\"\"><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField190\"><div class=\"vfb-form-group\"><label for=\"vfb-field-190\" class=\"vfb-control-label\">Applicant Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-190\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-190\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField191\"><div class=\"vfb-form-group\"><label for=\"vfb-field-191\" class=\"vfb-control-label\">Street Address <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-191\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-191\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField192\"><div class=\"vfb-form-group\"><label for=\"vfb-field-192\" class=\"vfb-control-label\">City <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-192\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-192\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField193\"><div class=\"vfb-form-group\"><label for=\"vfb-field-193\" class=\"vfb-control-label\">State <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-193\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-193\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField194\"><div class=\"vfb-form-group\"><label for=\"vfb-field-194\" class=\"vfb-control-label\">Zip <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-194\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-194\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-phone\" id=\"vfbField195\"><div class=\"vfb-form-group\"><label for=\"vfb-field-195\" class=\"vfb-control-label\">Cell Phone <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-195\" class=\"vfb-form-control vfb-intl-phone\" placeholder=\"\" required=\"required\" type=\"tel\" name=\"vfb-field-195\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField196\"><div class=\"vfb-form-group\"><label for=\"vfb-field-196\" class=\"vfb-control-label\">Email <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-196\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-196\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField197\"><div class=\"vfb-form-group\"><label for=\"vfb-field-197\" class=\"vfb-control-label\">University Attending <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-197\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-197\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField198\"><div class=\"vfb-form-group\"><label for=\"vfb-field-198\" class=\"vfb-control-label\">Advisor <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-198\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-198\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField218\"><label for=\"vfb-field-218\" class=\"vfb-control-label\">Status (Check all that apply) <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-218-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-218\" required=\"required\" type=\"checkbox\" name=\"vfb-field-218[0]\" value=\"1\">Full-Time<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-218-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-218\" type=\"checkbox\" name=\"vfb-field-218[1]\" value=\"1\">Part-Time<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-218-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-218\" type=\"checkbox\" name=\"vfb-field-218[2]\" value=\"1\">First Year Graduate<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-218-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-218\" type=\"checkbox\" name=\"vfb-field-218[3]\" value=\"1\">Second Year Graduate<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-218-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-218\" type=\"checkbox\" name=\"vfb-field-218[4]\" value=\"1\">Undergraduate + Graduate (Part-Time)<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField201\"><div class=\"vfb-form-group\"><label for=\"vfb-field-201\" class=\"vfb-control-label\">Previous Degree(s) Earned<\/label><div><textarea id=\"vfb-field-201\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-201\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField202\"><div class=\"vfb-form-group\"><label for=\"vfb-field-202\" class=\"vfb-control-label\">Major\/Institution\/Granted<\/label><div><textarea id=\"vfb-field-202\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-202\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField203\"><div class=\"vfb-form-group\"><label for=\"vfb-field-203\" class=\"vfb-control-label\">Employer, if applicable<\/label><div><input id=\"vfb-field-203\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-203\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField205\"><label for=\"vfb-field-205\" class=\"vfb-control-label\">Have you been a recipient of a KSHA scholarship or research grant in a previous year: <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-radio\"><label><input id=\"vfb-field-205-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-205\" value=\"Yes\">Yes<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-205-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-205\" value=\"No\">No<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField206\"><div class=\"vfb-form-group\"><label for=\"vfb-field-206\" class=\"vfb-control-label\">Year Received<\/label><div><input id=\"vfb-field-206\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-206\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField207\"><div class=\"vfb-form-group\"><label for=\"vfb-field-207\" class=\"vfb-control-label\">Amount Received<\/label><div><input id=\"vfb-field-207\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-207\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-textarea\" id=\"vfbField208\"><div class=\"vfb-form-group\"><label for=\"vfb-field-208\" class=\"vfb-control-label\">Are you currently receiving any financial aid\/scholarship\/grant funding? If yes, please indicate the amount, type and name of your financial aid\/scholarship(s).<\/label><div><textarea id=\"vfb-field-208\" class=\"vfb-form-control\" placeholder=\"\" rows=\"10\" name=\"vfb-field-208\" cols=\"50\"><\/textarea><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-instructions\" id=\"vfbField209\"><div class=\"vfb-form-group\"><label for=\"vfb-field-209\" class=\"vfb-control-label\">Upload your transcript, resume, essay and letters of recommendation.  The file names should include your name and document type (e.g., Smith-Resume, Smith-Essay...).<\/label><div class=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField210\"><div class=\"vfb-form-group\"><label for=\"vfb-field-210\" class=\"vfb-control-label\">Transcript <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-210\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" required=\"required\" type=\"file\" name=\"vfb-field-210\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField211\"><div class=\"vfb-form-group\"><label for=\"vfb-field-211\" class=\"vfb-control-label\">Resume <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-211\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" required=\"required\" type=\"file\" name=\"vfb-field-211\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField212\"><div class=\"vfb-form-group\"><label for=\"vfb-field-212\" class=\"vfb-control-label\">Essay <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-212\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" required=\"required\" type=\"file\" name=\"vfb-field-212\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField213\"><div class=\"vfb-form-group\"><label for=\"vfb-field-213\" class=\"vfb-control-label\">Recommendation Letter 1 <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-213\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" required=\"required\" type=\"file\" name=\"vfb-field-213\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-file-upload\" id=\"vfbField214\"><div class=\"vfb-form-group\"><label for=\"vfb-field-214\" class=\"vfb-control-label\">Recommendation Letter 2<\/label><div><input id=\"vfb-field-214\" class=\"vfb-form-control vfb-file-input\" placeholder=\"\" type=\"file\" name=\"vfb-field-214\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField215\"><button id=\"vfb-field-215\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><\/form>\n","protected":false},"excerpt":{"rendered":"<p>RISE Scholarship Deadline: January 15 Application and Supporting Documents Deadline: Forms must be submitted electronically, using the online form below or via email by January 15. The minimum criteria to apply for KSHA\u2019s Diversity, Equity, Inclusion Scholarship are: Evidence of academic achievement at the doctoral, graduate and\/or undergraduate level. Transcript showing current GPA (no minimum required) and enrollment in a speech\u2010language pathology or audiology training program. KSHA membership. Demonstrated service or commitment to diversity, equity, and inclusion through service and organizational participation Essay and Resume Letters of Recommendation. Award recipient agrees to: Write an article for the KSHA Communicator describing how the award was used and what it meant to them to win. The documentation listed below must be submitted together and received via electronic submission or mail no later than January 15: Completed application &#8211; Printable document or online submission available below. Transcript to validate your GPA and program enrollment. While there is no minimum GPA required for this application, the GPA will be considered in the selection process. Current r\u00e9sum\u00e9 showing your academic achievement, employment history and relevant activities the doctoral, graduate and\/or undergraduate level. A typewritten 250\u2010500 word essay that includes: Future plans and goals as a Speech\u2010Language Pathologist or Audiologist Discuss how your experiences related to aspects of diversity, equity, and inclusion can contribute to enhancing the field of communication sciences and disorders. These experiences may be personal, academic and clinical, and\/or community based Letters of Recommendation from two of your program faculty written on your school\u2019s letterhead. The recommenders should address your financial situation, your ability to complete a graduate program and\/or conduct research, or other information relevant to your application. Note: The scholarship is typically valued at $2,000 each but is subject to change due to budgetary limits. A recipient may reapply in a future year. Option 1: Printable Application Form Printable Application Please address questions to: ksha.scholarships@ksha.info or 800\u2010837\u20102446. Option 2: Online Application Form Use the following online form. Please note when using the online form, you will also need to upload all of the supporting documentation at the same time as submitting the form.<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2028","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/pages\/2028","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/comments?post=2028"}],"version-history":[{"count":0,"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/pages\/2028\/revisions"}],"wp:attachment":[{"href":"https:\/\/ksha.info\/index.php\/wp-json\/wp\/v2\/media?parent=2028"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}