CK Life SURGERY SCHOLARSHIP FUND

 
 
 
APPLICATION NUMBERS now available. 
To receive an application number Email: Scholarshipfund@cklife.org


Our Surgery Scholarship Application cycle #5 Begins January 1st, 2015 at 12 AM EST and End April 1st at 3am EST.

Applications MUST be received by April 1st, 2015 at 3am EST to be considered for a scholarship.
 
 
****LATE Applications will NOT be Accepted. ****
 
We will be notifying ALL  applicants of a Decision regarding their application by:
JUNE 1st, 2015
(Date subject to change if more time needed to review applications) 
 
If you have any questions please   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 PROFESSIONAL letters postmarked by:
April 1st, 2015 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
          - Contact Info (Email and/or Telephone)
          - Must State which ONE Surgery* you are asking for assistance accessing.
 
*ONE surgery must be selected per application number (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.
 
*If you would like to be considered for different types of surgery you may request a different application number for each type of surgery but you must complete an entire application for each application number.

          - Name of Surgeon(s) you prefer to go to along with the surgeons contact info. An alternate surgeon MUST be named. I no alternate surgeon listed an explanation must be given. 
        
 
II.  Personal Statement
       - Write a personal statement of no more than 1000 words. (Anything beyond 1000 words will NOT be read. 
       - 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 (Please be as specific as possible).
 
       - What will you do to try and afford surgery if you are not granted a scholarship (Be as specific as possible)
  
  


 
 
 
III. Professional Letter
        - One letter from a Medical OR Mental Health Provider.
    Acceptable Providers: MDs, DOs,PHDs Nurse Practitioners, Psychiatrists, Social Workers, therapists, 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 your 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 someone you know stating why they think we should pick you for a surgery scholarship in terms of what they know about your               need for surgery. 
         - Contact information should be included because the individual may be contacted for clarification and/or verification.
         - Must be a maximum of 500 words. (Anything over 500 words Will NOT be read)
 
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 etc.)
        - Amount still needed toward surgery
        - State whether or not you have insurance. If you have insurance state what kind and why you are  unable to use it for surgery.
 
 
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 opportunities.
 
 
 
Selection of scholarship recipients will be done by a CK Life affiliates 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: MAY 1st, 2015.
 
If you are selected for funding all Money will be paid directly to the Surgeon(s) or Hospital/surgical facility.
 
Any awarded funds MUST be used within 3 months (for all non genital surgery procedures) 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**
 
 
 
 
 
CK Life is available to do sensitivity trainings 
and consultations upon request.

Questions or comments?
(347)881-7005
(347)866-9002
CK Life is a Non-Profit organization. Federally recognized as a 501(c)3. 

Please help by donating so that we might continue to do this work.



If you would like CK Life Apparel, go to the CK Life Shop! 
100% of the proceeds go to the Scholarship Fund.

Community Kinship Life™ Copyright ©2010-2013. Designed and Maintained by 8DACE Interactive Media Ent. All rights Reserved.