2026 Conference Scholarship Application Form

Sonsored by the PA Commission on Crime and Delinquency.

Please enter your information.

Name

First Name

Last Name

Email

Company

Address

City

State/Province

Zip/Postal

County

Applicant Agency/Coalition Description

Does your organization or coalition currently receive PCCD funding?

Yes

No

Please provide a brief financial statement of need.

0 of 40 max words

How will attending the conference benefit your prevention efforts?

0 of 40 max words

Do you reside or work 50 or more miles from the Harrisburg - Hilton (One N. Second Street, Harrisburg, PA 17101)

Yes — By selecting this option, you certify that this information is accurate and acknowledge that you will receive three nights of lodging (June 9-11).

No — You do not qualify for lodging support.

By checking the box below, I agree to the scholarship application guidelines and agree with the eligibility, requirements, attendance, terms and conditions, and cancellation policy of receiving a scholarship?

Yes, I agree.