ALT Scholars Internet Connectivity Bursary Form

Participation from all ALT alumni is a critical measure of the success of the ALT 2021 Extension. The purpose of the bursary is to support those in need with financial support when no other help is available.

All answers are confidential.

We appreciate that your time is valuable, and accordingly anticipate that this form will take no more than five minutes to complete.

1. Is access to fast, reliable Internet a barrier to your participation in the Leadership Certificate Program offered online from June to September 2021?
*This question is required.

2. If yes, do you have access to any other support (financial or other means) for fast, reliable Internet? This information is helpful for our review. If, for example, you have access to the Internet through your work, but not at home, you are still able to apply for this bursary.

3. Are you currently located in Africa?
*This question is required.

4. What is the cost of Internet access on a monthly basis? Please note that funding is only available for four months from June to September 2021. *This question is required.

5. Please use this space for additional comments.

6. Contact Information *This question is required.

Full Name
Email Address
Phone Number
WhatsApp Number (if available)
City
Country

By completing this form, you give us permission to contact you to follow-up on your request.