Scholarship Request Form

Phone Number *

Name: *

Why do you need a scholarship for Rule 62? *

Are you able and willing to make the commitment to attend every session all 3 days? *

Yes

Sobriety Date *

Have you received a Rule 62 scholarship in the past? *

Yes

Are you a member of Alcoholics Anonymous *

Yes

“Rule 62 AA Woodstock of ND Conference Scholarship Request Form”

Limited Number of Scholarships Available

Instructions to request a Rule 62 scholarship:

The only way to receive a scholarship for the Rule 62 conference is to complete this form.

Due date of scholarship request is at midnight on Dec 31, 2024.

Scholarships are not granted in the order that they are received, but will be based upon the information provided on the request form.

The “Rule 62 Scholarship Committee” will review all scholarships thoroughly. All scholarship recipients will be notified via phone call by Jan 8th, 2025.

If you are not contacted by phone on Jan 8th, you did not receive one of the Rule 62 scholarships. NO scholarships for the Rule 62 will be awarded after Dec 31th and there will not be any available at the door.

Thank you for your cooperation,

R62R Scholarship Committee

What amount, if any, are you able to pay towards the cost of your registration? *

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Are you currently employed? *

Yes