* 1. Name

* 2. Contact information (phone number & email address)

* 3. CES-NS membership #

* 4. Are you currently a CES-NS member in good standing?

* 5. Are you willing and able to attend the 2018 CES National Conference in Calgary May 26th-29th?

* 6. Are you willing to provide CES-NS with content related to your attendance at the conference (e.g. blog post)?

* 7. What type(s) of support are you applying for? Check all that apply

* 8. Please describe how you demonstrate engagement with the provincial and/or national chapters and broader evaluation community.

* 9. Please provide a brief rationale for why this support is required for our attendance at the conference.

* 10. What particularly about the conference theme Co-creation intrigues you?

* 11. How will your utilize and share the learning and insights from the conference?

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