County Mental Health Focal Person Application

2nd National Mental Health Conference 2025

10 slots available for focal persons

Personal Info

Professional

Statement

Plans

Documents

Commitment

Personal Information

Please provide your basic personal details

Personal Information

First Name

Middle Name

Last Name

Phone Number

Email Address

National ID Number

Professional Information

Details about your current role and county

County

Years in Current Position

Current Position Title

County Health Department

Statement of Intent

Describe your active role in county mental health and alignment with conference objectives (300 words maximum)

Statement of Intent

0/300 words

Post-Conference Application Plans

Describe how you will disseminate or apply learnings locally (300 words maximum)

Post-Conference Plans

0/300 words

Required Documents

Please upload the required supporting documents

Appointment Letter

Upload Appointment Letter
PDF, JPG, or PNG (Max 5MB)

Endorsement Letter

Upload Endorsement Letter
PDF, JPG, or PNG (Max 5MB)

Upload endorsement letter from County Director of Health or County Mental Health Coordinator

Commitment

Please confirm your commitment if selected

I commit to seeking support for my logistics including travel and accommodation as per SRC guidelines. I understand this is a requirement for scholarship recipients.

Important Information

Transport & Accommodation: Selected scholarship applicants must commit to seeking support for their logistics including travel and accommodation as per SRC guidelines.
Review Process: Applications will be reviewed by the Scientific Committee using standard scoring criteria.
Notification: You will be notified of the outcome via email within 2 weeks of submission.
Limited Slots: Only 10 focal person scholarships are available nationwide.
Selection Criteria: Priority given to focal persons from marginalized counties and those demonstrating strong commitment to mental health.

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