2010 Rachel Warner Scholarship Program Information Form & Application
On May 2, 1995 the hemophilia community lost a true friend and advocate with the untimely death of Rachel Warner. Rachel was the wife of Ralph Warner and the proud mother of Rebecca Warner and was a valued member of the hemophilia community. A bit of an enigma, she has been described at various times as an intense whirlwind, a true character, a dedicated advocate, and most if all, a caring and loving human being.
Rachel was a very special person. She was loved and respected by everyone who came to know her. Rachel accomplished more in her 41 years than most people will achieve in a lifetime. She was also a friend and advocate to may outside the hemophilia community. In essence, she as an irrepressible and irascible advocate for all persons afflicted with chronic disorders.
Among her many accomplishments she was the President and Chairwoman of the legislation committee of the Florida Chapter of the National Hemophilia Foundation, and committee member for Camp H.A.W.K. (Hemophiliacs Are Wonderful Kids). She successfully lobbied to save Florida's high risk pool (persons unable to obtain regular health insurance), while also serving on the Ryan White CARE Act Title II AIDS Treatment Council for the State of Florida. She developed and implemented the A.C.C.E.S.S. Program (Advocating for Chronic Conditions, Entitlements and Social Services) at Gentiva which has ensured that hundreds of individuals and families have continuing access to medical coverage and support programs.
Rachel successfully lobbied to allow hemophilia clotting factor to be paid for by the Florida Medicaid program, and was at the forefront of efforts to overcome the many barriers to gaining disability benefits for persons with hemophilia. In fact, she never lost a single dispute over a disability classification of a person with hemophilia. Rachel played a critical role in shaping the future of hemophilia care in Florida as well as across the country.
The ACCESS program she founded remains a success due to the diligence and outstanding work of Kim Bernstein who, chosen and trained by Rachel, was willing to take over the program and continue this critical work established by Rachel Warner.
Application Form:
Committee of Ten Thousand
Advocates for Persons with HCV/HIV/AIDS
236 Massachusetts Ave., NE Suite 609
Washington, DC 20002
Rachel Warner Memorial Scholarship Program
Application Form -- Fall 2010
Due May 1, 2010
Name: _________________________________________________________________
Address: _________________________________________________________________
City:_______________________________ State: ___________ Zip Code: _______________
Home Phone: ( ) ___________ Work Phone: ( ) _____________
Cell Phone: ( ) ____________
Date of Birth Month: ______ Day: _____ Year: ______
Bleeding Disorder Diagnoses: _________________________________________________________
How did you hear of the scholarship: ______________________________________________
List Special School Activities to Date: ____________________________________________
List any Honors / Awards Received :___________________________________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Proposed School:
Name:
_______________________________________________________
Address: _______________________________________________________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Father's Name: ____________________________
Phone: ( ) ______________
Mother's Name: ___________________________
Phone: ( ) ______________
Siblings: (Name and age for each) ________________________________________________
Family Total Annual Income: $ __________________________
Applicant Total Annual Income: $ __________________________
Estimated Expenses for the School Year: $___________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Include a one-page essay about your past and proposed future plans. Also include a one-page letter from a teacher or instructor briefly describing you. Return all materials to the above address.
COTT is an Independent, Peer-Led, Grassroots Non-Profit Organization