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Perez Scholarship Application

The Perez Scholarship Application is for students who need to purchase the Traditional CAPPA Academy course for certification. This scholarship does not cover the costs of training, materials, books, etc. also required for successful completion of certification requirements.

  • Please list the email that is best used to contact you.
  • Please list the phone number that is best to reach you at.
  • Be certain to include the details below for each course of study: Title of Course or Program of Study Brief description School or organization providing the course/program Website Physical location (if online please indicate as such) Enrollment Date and Completion Date *If currently enrolled or you do not plan to go on to completion you will need to note that, as well as the reason for not completing the course.
  • Briefly tell us what led you on the path toward becoming a perinatal professional. Additionally, should you be awarded The Perez Scholarship and pass the course; how do you foresee using your certification (your role) within your community?
  • Please provide a brief explanation as to why you are in need of financial assistance in furthering your career path, more specifically, this course and scholarship opportunity.
  • Which CAPPA Academy Course are you applying for regarding The Perez Scholarship opportunity?
  • All Perez Scholarship Applicants must have either attended or plan on attending an in-person training with a CAPPA Approved Faculty instructor.
  • Select the date of the first day of the training you have attended or will attend in the future.
    MM slash DD slash YYYY
  • This must correspond with CAPPA Academy course you are applying this scholarship for.
  • If selected, I understand that my first initial and last name will be published on the CAPPA Scholarship webpage and CAPPA E-newsletter. Please type your full name below to indicate that you agree.

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