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2026 UTF OPEN REGISTRATION
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Apply for a scholarship using the form below.
General Information
Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email
(Required)
Personal Information
What makes you adaptive?
(Required)
Amputee
Spinal Cord Injury
Traumatic Brain Injury
Neurological
Congenital
Amputation Type
(Required)
Above/Below Knee
Above/Below Elbow
Unilateral
Bilateral
Spinal Cord Injury Type
(Required)
Select
Cervical
Thoracic
Lumbar
Neurological Type
(Required)
Select
MS
Epilepsy
Other
Date of Injury
(Required)
Do you have a Criminal Record?
(Required)
Select
No
Yes
Do you use a wheelchair?
(Required)
Select
No
Yes
Have you applied before?
(Required)
Select
No
Yes
Health History
Medications, Injuries, Surgeries
Photo of yourself
(Required)
Accepted file types: png, jpeg, jpg, gif, Max. file size: 20 MB.
The Reason You're Here
Please answer and describe why to the following.
Where are you right now?
(Required)
Where do you project you'll be in 3-5 years?
(Required)
Where were you one year ago?
(Required)
Do you believe you are in control of your health and wellness?
(Required)