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Assistive Technology Scholarship
Student's Name
Student's Penn ID
Student's Penn Email
Do you authorize Disability Services to determine your financial eligibility for scholarships? Only your name and type of scholarship for which you qualify will be shared with Student Registration and Financial Services. There will be no disclosure about your disability.
yes
No
Describe the assistive technology and how it will benefit you in relation to your disability.
Describe your academic and/or career goals or any special interest or hobbies.
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