Selective Mutism in the School Conference Financial Assistance Application

Mr. B Financial Assistance Award

In honor of Dr. Shipon-Blum's first therapy dog, Mr. B, the SMart Center has created the “Mr. B Scholarship Program.” This program allows us to offer qualifying families the opportunity to receive admission to the Selective Mutism in the School Virtual Conference on April 4th, 2025. If selected for this award, you will be contacted with more information.

Directions: Please complete this application and submit with the additional materials necessary for the award. Applications should be submitted by March 4th, 2025.

First & Last Name: *

Email Address: *

Phone Number: *

Mailing Address: *

Please write a short statement explaining your financial situation. *

Please upload your 2 most recent paystubs. *

Please upload a copy of your photo ID. *