Individual Scholarship Application

Thanks to our generous donors, ASM is now offering funding for individuals via our new Scholarship Program. We recognize that there are students out there that would like to take our program, but may not be able due to financial difficulty. We don’t want this to stand in the way of a bystander being certified and able to help at the scene of a crash. Our training saves lives, and that’s something that is priceless!

If you or someone you know are experiencing financial hardship, but would like training, please fill out the application below to see if you qualify for training at a reduced cost. Please note this application is for individual students that are seeking financial assistance. If you are seeking reduced pricing for a group, please contact us by filling out a form HERE.

Scholarship Application

Name(Required)

First Last

Address(Required)

Street Address City State ZIP Code

Phone(Required)

Email(Required)

Date and Location of Class(Required)

Due to financial hardship, I am requesting for assistance with tuition(Required)

Yes

I understand that submitting this form does not guarantee I will be approved for a scholarship(Required)

Yes

I understand there may still be a small fee associated to take the course (not to exceed $25)(Required)

Yes

In a few sentences, please tell us why getting trained in bystander assistance is important to you(Required)

If contacted by ASM afterward, would you be willing to tell us what you thought of the training?(Required)

Yes

By typing your name below, you are acknowledging and certifying that all of the answers you have given are true to the best of your knowledge(Required)

(Full First and Last Name)