Caregiver Grant Application

Apply for a Road Scholar Caregiver Grant
Application Type
Please read these instructions carefully before applying for a Grant.

In order to submit this online form, you will need to upload an electronic copy of your financial documentation.

Please complete one application per person. In order to be reviewed by the Financial Assistance Committee, all parts of the application must be complete, including the program number and date for which you are applying. Please answer the questions thoughtfully and thoroughly. Your answers will be used to determine eligibility, and incomplete applications will not be reviewed.

We cannot review an application for a program with a start date of less than eight (8) weeks from your application date, a sold-out program, a program that has passed the final payment date or for an enrollment that has already been paid in full.

The review of an application takes 4-6 weeks once it has been received by the committee; applications are reviewed in the order that they are received and cannot be expedited. Therefore, please ensure that you are submitting this application early enough to allow time to enroll and make your travel arrangements after you receive your award letter.

We recommend that you apply at least three (3) months prior to your selected program start date.

If you have any questions regarding scholarships, you may contact us by emailing scholarships@roadscholar.org.

Print-friendly version of the application
Personal Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Where did you learn about the Road Scholar Caregiver Grant program?
Information of Person for Whom You Provide Care
Name

First NameLast Name
Relationship
Nature of illness or disability
How long have you been this person's caregiver?
Living Situation
Program Information

Please provide the following information about the program for which you want to register (pending availability):
Program Name
Please choose a program that takes place in the U.S. or Canada.
Program Number
Program Date

MonthDayYear
Enter the program start date listed in print or on our website.
Double or Single Occupancy
Deposit Amount
Please note the deposit amount can vary by program. See the program page for required deposit amount.
Total Program Cost (Up to $2,500)
Please note that the prices published on the web and in print vary by date and by single or double occupancy. The total program price for your specific date and rooming selection must be $2,500 or less. No exceptions can be made.
Caregiving Expenses/Detail Information
The Road Scholar Caregiver Grant is financial assistance to attend a Road Scholar educational adventure. Please provide details of your caregiving expenses that help demonstrate your need for financial aid.

If you are arranging substitute care for the time that you will be on the program, please list, detail and provide the estimated cost of substitute caregiver arrangements necessary and attach copies of relevant documentation (i.e. hourly respite care services or the cost of an airline ticket for another family member to fly to your home to provide substitute care).

Otherwise, please list, detail and provide the estimated monthly expenses that your household incurs (or incurred) for your loved one i.e. skilled and unskilled care; co-payments; home modifications; etc. and attach copies of relevant documentation.

You may also upload your most recent tax return to demonstrate financial need.
Please provide information about your caregiving expenses.
Attach File(s)

Limited to 2 files max. Accepted formats: Pdf, doc, and docx.
Cancelof
Personal Statement
The purpose of the personal statement is to help determine why Road Scholar should award you a Caregiver Grant. Please tell us, in specific detail, why you want to learn with Road Scholar and how the experience would impact you as a caregiver. Please include any special circumstances or personal experiences that have influenced your program selection and/or your request for financial aid. This essay is used to help us determine need. When funds are limited, the personal statement can be the deciding factor between one application or another.
Note: 250-500 words are required.

0/500
Tell Us About Yourself
Are you:
Gender
Race

Other
Ethnicity
Please indicate your highest level of educational achievement (select one):

Other
Employment Status:

Other
If employed, please tell us in what profession/occupation; if retired, please tell us your last profession/occupation:
Please describe any employment changes related to your caregiving duties.
Terms and Conditions
Please read "The Basics: What You Need to Know About Caregiver Grants" listed here.

By signing this application, you are agreeing to abide by the terms and conditions of the Caregiver Grant program; to allow Road Scholar to use your personal statement and thank-you letter in reporting to our donors (and the public at large) how donations to Road Scholar are being used; and to be identified in those materials by your first name, last initial, city and state (e.g. Mary S., Omaha, Nebraska).

Your financial and contact information will always remain completely confidential.

Please digitally sign this application by entering your full name and the date below.
Signature
Please enter your name
Date

MonthDayYear
Date
Please use this checklist to ensure that you are submitting all of the information required for the Caregiver Grant Committee to review your application.

After you hit the Submit button, you will see a confirmation page. If you do not see the confirmation, there is an error with your submission. Please scroll down the page to view the field(s) that need attention.

Incomplete applications will not be reviewed.
Checklist:
Should be Empty:

Apply for a Road Scholar Caregiver Grant

Please read these instructions carefully before applying for a Grant.

Personal Information

Information of Person for Whom You Provide Care

Program Information

Caregiving Expenses/Detail Information

Personal Statement

Tell Us About Yourself

Terms and Conditions

Please digitally sign this application by entering your full name and the date below.