CK Life SURGERY SCHOLARSHIP FUND
Our Surgery Scholarship Application cycle #3 will open SOON!
We will be accepting applications From:
June 1st, 2013 at 12:00Am EST until October 1st, 2013 3:00 AM EST.
Cycle 3 application numbers will start being given out NOW but applications will NOT be accepted until the scholarship cycle opens.
Email us at: scholarshipfund@cklife.org to receive your application number.
YOU MUST get an application number in order to submit your application.
****LATE Applications will NOT be Accepted. ****
COMPLETE Applications will be accepted by email ONLY! Applications must be in DOC or PDF Format. If not in either format application will be rejected and not considered for a scholarship.
Applications will be considered temporarily complete if all parts are complete but professional letter is pending. A notification of complete application will be given upon receipt of letter.
Email: Scholarshipfund@cklife.org
We will accept Provider letters by mail if provider unwilling to give letter directly to applicant to email with application. If this is the case please state it in the application under Professional letter section.
Only mailed letters postmarked by:
October 1st, 2013 will be accepted
Mail: Attn: CK Life Scholarship Fund
P.O. Box 6060
Bronx, NY 10451
Application Criteria:
I. Cover Page
- Name (Both Legal and Preferred if different)
- Date of Birth (Applicants must be age 18 By January 1st, 2013 to receive scholarship)
- Contact Info (Email and/or Telephone)
- Must State which ONE Surgery* they are asking for assistance accessing
*ONE surgery must be selected (hysterectomy With GRS will count as one surgery. Multiple FFS which are performed by the same surgeon in one operation will count as ONE surgery.
- Name of Surgeon(s) you prefer to go to. An alternate surgeon may be named as well if still deciding
II. Personal Statement
- Write a personal statement of no more than 1000
- Detail what efforts you have made to fund raise or save towards your surgery
- Please include in this statement who will care for you and provide support post surgery
- Include how having surgery will impact your life
III. Professional Letter
- One letter from a Medical OR Mental Health Provider.
Acceptable Providers: MDs, DOs, Nurse Practitioners, Psychiatrists, Social Workers, therapists, licensed/Certified Counselors (if any questions about your provider email us)
- Letter must state how long you have been in transition and what steps you have taken/completed in yoru transition process.
Note: We understand there is no one way to transition but applicants must meet WPATH standards of care with regards to being eligible for scholarship approval. For a list of standards check out the WPATH.
IV. Personal Reference
- From a family member, friend/associate or co-worker stating why they think we should pick you for a surgery scholarship
- Contact information should be included
- Must be a maximum of 500 words.
V. Financial Statement
- State Annual income and source of income
- Annual Expenses
- Amount Saved towards surgery, if any, with a break down (I.e. $500 for Travel saved, $1,000 towards surgery saved)
- Amount needed toward surgery
- State whether or not you have insurance. If you have insurance state what kind.
All Applicants will be given an application number. You can request an application number by emailing scholarshipfund@cklife.org . This number must be included on each page of application materials to help keep track of application.
***Any Statements in the application found to be knowingly incorrect/untrue will eliminate applicant from current scholarship cycle and any future scholarship cycles.
Selection of scholarship recipients will be done by a CK Life affiliate with name being omitted from the application to keep the selection unbiased. Applicants must meet WPATH standards to be granted a scholarship. All applicants will be notified of a final decision on their application. Date of Notifications will start going out February 1st, 2013.
If you are selected for funding all Money will be paid directly to the Surgeon or Hospital/surgical facility.
Any awarded funds MUST be used within 3 months (for Breast or Chest Surgery) or 6 months (for Genital surgeries) of time they are awarded. If there are extenuating circumstances (such as surgeon has a long waiting list) then that time frame may be extended based on the circumstances. If the funds are not used in an appropriate amount of time then the funds will go back into the pool of money towards the next scholarship Cycle.
If you have any questions or concerns regarding this application process please email: scholarshipfund@cklife.org
Due to our Nonprofit status you have to be a US citizen or legal resident in the US to receive a Scholarship
***We are always accepting donations for this surgery scholarship fund
You May Also
Mail checks and money orders made out to:
Community Kinship Life or CK Life
P.O. Box 6060
Bronx, NY 10451
Or
Contribute by Credit card below via our pay pal account
**All donations are Tax deductible**
100% of Proceeds from CK LIFE products go towards the SCHOLARSHIP FUND
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