Margaret Phillips Youth Mental Health Empowerment Scholarship

Youth Scholarship Information

**Please read through scholarship information before completing application**
Child's full name
Child's gender
Parent/Guardian’s full name
Do you currently receive any government assistance (welfare, food stamps, etc.)?
Is your child between the ages of 13 and 17?
Do we have consent from parents or caregivers to receive mental health treatment?
Can you commit to treatment in person or over telehealth for a minimum of 6 sessions?
Can you commit to participation based off the counselor’s recommendations for treatment?
Can we contact you for more information?
Max. file size: 35 MB.
By submitting this application, you certify that the information provided is accurate and complete to the best of your knowledge. You understand that this scholarship is granted based on financial need and the child's therapeutic requirements.