ANSWERS 2017 Conference Servicer Scholarship Application Question Title * 1. Contact Information First Name: Last Name: Company: Job Title: Address State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming City: ZIP Code: Email Address: Phone Number: Question Title * 2. Supervisors Contact Information (list individual who approves your attendance to these types of events, if you self approve then skip this question). First Name: Last Name: Job Title: Email Address: Phone Number: Question Title * 3. Which scholarship are you applying for? Registration-Only Scholarship All-Inclusive Scholarship Customized Scholarship (complete details in Q4 below) Other (please specify) Question Title * 4. If you chose Customized Scholarship, select which of the following that you would need assistance with in order to attend the ALFN conference. Complimentary Conference Registration 3 nights hotel room & tax at the host hotel Coach class airfare (up to $400) Ground transportation (up to $110) Question Title * 5. What work do you currently do with your organization? Question Title * 6. What is your goal in attending this conference (what you would like to get out of your attendance)? Question Title * 7. Have you attended the conference before and, if so, how did it benefit you? Yes No If Yes, how did it benefit you? Question Title * 8. Describe your financial need for assistance, and why you need this assistance. Question Title * 9. How did you hear about the ALFN Servicer Scholarship Program? ALFN Email ALFN Website ALFN Member (List their name in the Other box below) ALFN Webinar ALFN Mailer ALFN Angle Publication ALFN Printed Materials (Save the Date Card or Brochure) The MReport Servicing Management HousingWire DSNews Other (please detail below) Other (please specify) Question Title * 10. Are you a servicing manager, executive (or general counsel) or other staff member who is a decision maker or decision influencer? Yes No Other (please specify) Question Title * 11. Are you a servicing manager, executive (or general counsel) or other staff member who has the ability to refer work or influence where files are sent to ALFN members? Yes No Other (please specify) Question Title * 12. Do you have any current or anticipated future file volume to refer in any particular state(s) and can meet with ALFN members at the conference to discuss opportunities? This will be used to introduce you to attorneys in states of need at the conference, and information provided will be kept internal with ALFN. Yes No Unsure If Yes, please indicate what types of files and state(s) Question Title * 13. Have you participated in any of the past ALFN functions? Check all that apply. ANSWERS - Annual Conference Advocacy Day - April DC WILLPower Summit - April DC Speaker at 2016 ANSWERS Conference Webinars TEACH Onsite Regional Servicer Training - Sept. 2016 Cincinnati TEACH Onsite Regional Servicer Training - Nov. 2016 Dallas Onsite Servicer Training at Servicers Location Bankrtupcy Intersect - Feb. 2017 Dallas ALFN Practice Groups, Task Forces or Boards None of the above Other (please specify) Question Title * 14. Do you agree to be available to all ALFN members during the conference to network and attend the group sessions, meals and networking functions of the annual conference? Yes No Other (please specify) Question Title * 15. Do you agree not to accept meeting or other event requests from other conference attendees (i.e. meetings, dinners, cocktails, etc.) that would conflict with a scheduled ALFN conference event? Conflicts to avoid would be during any group session, meals (breakfast, lunch, dinner or cocktail reception), group activity or any other event on the conference schedule. Yes No Other (please specify) Question Title * 16. Scholarship recipients agree to attend and be available to all ALFN members during the scheduled conference events (sessions, meals, receptions, group activities), and also agree not to accept an invitation from any ALFN conference attendee to meet that would conflict with a scheduled ALFN event. For example, no individual meetings, dinners, or other events should be done during any of the ALFN scheduled events. Scholarship recipients agree to participate on panels as invited and conduct at least two state-specific mini-meetings on Wednesday, July 19 with ALFN counsel from selected states (scheduled between 12:00 - 1:00PM) and ALFN ASSURE Member Rewards Luncheon (1:00 - 2:00PM). Conference concludes at 2:00PM Wednesday, July 19th. Yes No Other (please specify) Done