Workshop Assistance Program

Workshop Assistance Application

I am applying for assistance in attending the following NCPO workshop or National Form on Client Protection

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* 1. For which event are you requesting assistance?

NCPO Workshop

ABA National Forum on Client Protection

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* 2. Location of the event

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* 3. Dates of Event

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* 4. Contact Information

Name

Position/Title

Organization

Address

City/Town

State/Providence

Zip/Postal Code

Phone

Email

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* 5. Are you a member of NCPO?

Yes

No

If yes, date joined

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* 6. Is your organization a member of NCPO?

Yes

No

If yes, date joined

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* 7. Information about your Organization

Current annual operating budget

Assets

Number of Staff

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* 8. Have you, or any member of your organization, previously received a workshop assistance award?

Yes

No

If yes, please provide the dates of the workshops attended ad the name of the attendees who utilized the workshop assistance award.

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* 9. Please attach a statement providing the circumstance regarding your origination's inability to fully fund your participation at the NCPO workshop or the National Forum on Client Protection and what benefits you hope to derive from attendance at the event. Criteria may be found here Workshop Assistance

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* 10. I have read the criteria for the workshop assistance for which I am applying and I understand that the basis for an award is financial need. I hereby make application to NCPO for an award based on the inability of my organization to pay the full cost for me to attend the workshop.
Please type your name if you agree.