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<div><font face="Tahoma" size="2" style="font-size:10pt">Mona Robinson, PhD, LPCC-S, LSW, CRC A</font><span style="font-family:tahoma; font-size:small">ssociate Professor and Chair</span>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Department of Counseling and Higher Education</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Clinical Rehabilitation Program Coordinator</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Ohio University</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">The Gladys W. and David H. Patton College of Education </font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">N248 Lindley Hall</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="Tahoma" size="2">70 S. Court Street</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Athens, Ohio 45701</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">(740) 593-4461 phone</font></div>
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<div><font face="Tahoma" size="2">(740) 593-0477 fax</font></div>
<div><font face="tahoma" size="2"><a href="mailto:robinsoh@ohio.edu" id="LPNoLP">robinsoh@ohio.edu</a></font></div>
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<div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" color="#000000" style="font-size:11pt"><b>From:</b> CESNET-L is a unmoderated listserv concerning counselor ed. & supervision <CESNET-L@LISTSERV.KENT.EDU> on behalf of Hailey Martinez <marthail@ISU.EDU><br>
<b>Sent:</b> Tuesday, November 17, 2015 2:29 PM<br>
<b>To:</b> CESNET-L@LISTSERV.KENT.EDU<br>
<b>Subject:</b> 2016 ASGW Student Volunteer Scholarship</font>
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<p align="center" style="font-size:13px; margin:0in 0in 0.0001pt; text-align:center">
<b><i><span style="font-size:17pt; font-family:Cambria">ASGW Orlando Conference 2016</span></i></b></p>
<p align="center" style="font-size:13px; margin:0in 0in 0.0001pt; text-align:center">
<b><i><span style="font-size:17pt; font-family:Cambria">Student Volunteer Scholarship Application</span></i></b><span style="font-size:17pt"></span></p>
<p style="font-size:13px"><span style="font-size:11pt">The <b>Association for Specialists in Group Work (ASGW) Graduate Student Committee</b> is offering an exciting opportunity for graduate students to meet and interact with leading group </span><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">counseling
professionals at the </span><span style="font-size:11pt">Association for Specialists in Group Work 2016 National Conference in Washington, District of Columbia (February 18-20, 2016). </span></p>
<p style="font-size:13px"><span style="font-size:11pt">In return for <i>seven hours</i> of their time volunteering at the conference, graduate student volunteers will receive a $100 stipend.</span></p>
<ul type="disc" style="font-size:13px">
<li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Student volunteers need to be enrolled in a full-time graduate program at the time of the conference.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Student volunteers need to be current student members of ASGW.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Each applicant needs to electronically submit this application form along with a 500 word personal statement addressing the following 3 questions:</span></li></ul>
<ol start="1" type="1" style="font-size:13px">
<li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt"> How your professional development and leadership might be enhanced through conference attendance and involvement in professional organizations such as ASGW.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Any previous volunteer or conference activities and any reflections you have upon them.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Group work experience and/or why you are interested in Group Work during your graduate program.</span></li></ol>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt"> The application deadline to serve as a student volunteer is <b><i>December 6, 2015.</i></b> </span><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif"> Please note that
you will be contacted </span><span style="font-size:11pt">by <i>December 20<sup>th</sup> </i></span><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">if you have been selected as a volunteer scholarship recipient (priority is placed on a first
apply basis).</span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif"> </span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">I, ________________________, certify that I am a member of ASGW. My ASGW membership</span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif"> </span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">expires on ______________________.</span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt"> </span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:10pt; color:black"> <b>Name:</b> <i>(please print) </i>_________________________________________________________________ </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Address:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> _____________________________<b>City/State/Zip</b>____________________</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Day Phone #:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> (_____) ______-________ <b>Evening Phone #:</b> (_____)
______-_______</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Email:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">________________________________________</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Graduate program and University:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> _____________________________________________________</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px; margin-bottom:0.0001pt"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Signature:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> ______________________________________________Date:
__________________</span><span style="font-size:10pt; color:black"> <br>
<br>
<b></b></span></p>
<p style="font-size:13px; margin:0in 0in 0.0001pt"><b><span style="font-size:10pt; color:black">Faculty Attestation: I, <i>(print name)</i>_______________________________________________, of</span></b><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; color:black">(<i>school</i>)____________________________________________, confirm that the above student is a graduate</span></b><span style="font-size:10pt; color:black"> <b>student enrolled in classes
at my respective university.</b> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; color:black">Faculty Signature:___________________________________________________________________</span></b><b><span style="font-size:11pt; color:black"></span></b><span style="font-size:11pt; color:black"></span></p>
<p style="font-size:13px; margin:0in 0in 0.0001pt"><span style="font-size:11pt">Please email your completed application form and 500 word personal statement by</span></p>
<p style="font-size:13px; margin:0in 0in 0.0001pt"><b><span style="font-size:11pt">December 6<sup>th</sup>, 2015</span></b><span style="font-size:11pt"> to Hailey Martinez, </span><span style="font-size:11pt"><a href="mailto:marthail@isu.edu" target="_blank">marthail@isu.edu</a></span><span style="font-size:11pt; color:blue"></span><span style="font-size:11pt"></span></p>
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<span style="color:rgb(0,0,0); font-family:georgia,serif; font-size:small">Hailey N. Martinez, LPC, NCC</span><br>
</p>
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<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000">Doctoral Candidate</font></font></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000">Counselor Education and Counseling<br>
</font></font><span style="color:rgb(0,0,0); font-family:georgia,serif; font-size:small">Department of Counseling </span></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000">Idaho State University</font></font></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000"><a href="mailto:marthail@isu.edu" target="_blank">marthail@isu.edu</a></font></font><span style="color:rgb(0,0,0); font-family:georgia,serif; font-size:small"> </span></div>
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</font><span style="color:rgb(0,0,0)">"It is a great privilege to be human so that we can develop our humanity and be human in mind, in reality as well as in form."</span><span style="color:rgb(0,0,0)"> </span><font color="#000000"><br style="line-height:18px">
<span style="line-height:18px">� Hazrat Inayat Khan</span></font></font>
<div><font face="georgia, serif" size="2" color="#000000"><span style="line-height:18px"><br>
</span> CONFIDENTIALITY NOTICE: Email is not a confidential form of communication as it could potentially be accessed by unauthorized persons without your permission. This communication is for the sole use of the intended recipient and may contain confidential
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<div><font face="Tahoma" size="2" style="font-size:10pt">Mona Robinson, PhD, LPCC-S, LSW, CRC A</font><span style="font-family:tahoma; font-size:small">ssociate Professor and Chair</span>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Department of Counseling and Higher Education</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Clinical Rehabilitation Program Coordinator</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Ohio University</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">The Gladys W. and David H. Patton College of Education </font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">N248 Lindley Hall</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="Tahoma" size="2">70 S. Court Street</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">Athens, Ohio 45701</font></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif; font-size:16px"><font face="tahoma" size="2">(740) 593-4461 phone</font></div>
</div>
<div><font face="Tahoma" size="2">(740) 593-0477 fax</font></div>
<div><font face="tahoma" size="2"><a href="mailto:robinsoh@ohio.edu" id="LPNoLP">robinsoh@ohio.edu</a></font></div>
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<div id="divRplyFwdMsg" dir="ltr"><font face="Calibri, sans-serif" color="#000000" style="font-size:11pt"><b>From:</b> CESNET-L is a unmoderated listserv concerning counselor ed. & supervision <CESNET-L@LISTSERV.KENT.EDU> on behalf of Hailey Martinez <marthail@ISU.EDU><br>
<b>Sent:</b> Tuesday, November 17, 2015 2:29 PM<br>
<b>To:</b> CESNET-L@LISTSERV.KENT.EDU<br>
<b>Subject:</b> 2016 ASGW Student Volunteer Scholarship</font>
<div> </div>
</div>
<div>
<div dir="ltr">
<p align="center" style="font-size:13px; margin:0in 0in 0.0001pt; text-align:center">
<b><i><span style="font-size:17pt; font-family:Cambria">ASGW Orlando Conference 2016</span></i></b></p>
<p align="center" style="font-size:13px; margin:0in 0in 0.0001pt; text-align:center">
<b><i><span style="font-size:17pt; font-family:Cambria">Student Volunteer Scholarship Application</span></i></b><span style="font-size:17pt"></span></p>
<p style="font-size:13px"><span style="font-size:11pt">The <b>Association for Specialists in Group Work (ASGW) Graduate Student Committee</b> is offering an exciting opportunity for graduate students to meet and interact with leading group </span><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">counseling
professionals at the </span><span style="font-size:11pt">Association for Specialists in Group Work 2016 National Conference in Washington, District of Columbia (February 18-20, 2016). </span></p>
<p style="font-size:13px"><span style="font-size:11pt">In return for <i>seven hours</i> of their time volunteering at the conference, graduate student volunteers will receive a $100 stipend.</span></p>
<ul type="disc" style="font-size:13px">
<li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Student volunteers need to be enrolled in a full-time graduate program at the time of the conference.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Student volunteers need to be current student members of ASGW.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Each applicant needs to electronically submit this application form along with a 500 word personal statement addressing the following 3 questions:</span></li></ul>
<ol start="1" type="1" style="font-size:13px">
<li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt"> How your professional development and leadership might be enhanced through conference attendance and involvement in professional organizations such as ASGW.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Any previous volunteer or conference activities and any reflections you have upon them.</span></li><li class="MsoNormal" style="margin-left:15px"><span style="font-size:11pt">Group work experience and/or why you are interested in Group Work during your graduate program.</span></li></ol>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt"> The application deadline to serve as a student volunteer is <b><i>December 6, 2015.</i></b> </span><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif"> Please note that
you will be contacted </span><span style="font-size:11pt">by <i>December 20<sup>th</sup> </i></span><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">if you have been selected as a volunteer scholarship recipient (priority is placed on a first
apply basis).</span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif"> </span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">I, ________________________, certify that I am a member of ASGW. My ASGW membership</span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif"> </span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt; font-family:TimesNewRomanPSMT,serif">expires on ______________________.</span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:11pt"> </span></p>
<p class="MsoNormal" style="font-size:13px"><span style="font-size:10pt; color:black"> <b>Name:</b> <i>(please print) </i>_________________________________________________________________ </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Address:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> _____________________________<b>City/State/Zip</b>____________________</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Day Phone #:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> (_____) ______-________ <b>Evening Phone #:</b> (_____)
______-_______</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Email:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">________________________________________</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Graduate program and University:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> _____________________________________________________</span><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px; margin-bottom:0.0001pt"><b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black">Signature:</span></b><span style="font-size:10pt; font-family:TimesNewRomanPSMT,serif; color:black"> ______________________________________________Date:
__________________</span><span style="font-size:10pt; color:black"> <br>
<br>
<b></b></span></p>
<p style="font-size:13px; margin:0in 0in 0.0001pt"><b><span style="font-size:10pt; color:black">Faculty Attestation: I, <i>(print name)</i>_______________________________________________, of</span></b><span style="font-size:10pt; color:black"> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; color:black">(<i>school</i>)____________________________________________, confirm that the above student is a graduate</span></b><span style="font-size:10pt; color:black"> <b>student enrolled in classes
at my respective university.</b> </span></p>
<p style="font-size:13px"><b><span style="font-size:10pt; color:black">Faculty Signature:___________________________________________________________________</span></b><b><span style="font-size:11pt; color:black"></span></b><span style="font-size:11pt; color:black"></span></p>
<p style="font-size:13px; margin:0in 0in 0.0001pt"><span style="font-size:11pt">Please email your completed application form and 500 word personal statement by</span></p>
<p style="font-size:13px; margin:0in 0in 0.0001pt"><b><span style="font-size:11pt">December 6<sup>th</sup>, 2015</span></b><span style="font-size:11pt"> to Hailey Martinez, </span><span style="font-size:11pt"><a href="mailto:marthail@isu.edu" target="_blank">marthail@isu.edu</a></span><span style="font-size:11pt; color:blue"></span><span style="font-size:11pt"></span></p>
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<span style="color:rgb(0,0,0); font-family:georgia,serif; font-size:small">Hailey N. Martinez, LPC, NCC</span><br>
</p>
</div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000">Doctoral Candidate</font></font></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000">Counselor Education and Counseling<br>
</font></font><span style="color:rgb(0,0,0); font-family:georgia,serif; font-size:small">Department of Counseling </span></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000">Idaho State University</font></font></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000"><a href="mailto:marthail@isu.edu" target="_blank">marthail@isu.edu</a></font></font><span style="color:rgb(0,0,0); font-family:georgia,serif; font-size:small"> </span></div>
<div dir="ltr"><font face="georgia, serif" size="2"><font color="#000000"><br>
</font><span style="color:rgb(0,0,0)">"It is a great privilege to be human so that we can develop our humanity and be human in mind, in reality as well as in form."</span><span style="color:rgb(0,0,0)"> </span><font color="#000000"><br style="line-height:18px">
<span style="line-height:18px">� Hazrat Inayat Khan</span></font></font>
<div><font face="georgia, serif" size="2" color="#000000"><span style="line-height:18px"><br>
</span> CONFIDENTIALITY NOTICE: Email is not a confidential form of communication as it could potentially be accessed by unauthorized persons without your permission. This communication is for the sole use of the intended recipient and may contain confidential
or privileged information. Any unauthorized review, disclosure, distribution, or other use of this email is prohibited. If you received this email in error, please notify the sender and destroy all copies of the original message.</font><br>
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