The version of the browser you are using is no longer supported. Please upgrade to a
Request edit access
Coalesce Leadership Retreat: Travel & Lodging Stipend Application
Our objective for participants of the leadership retreat is to STRENGTHEN the AAPI leaders of tomorrow, CONNECT them with like-minded individuals around their region, and EMPOWER them to put advocacy into action.
School or Organization Affiliated with
I am traveling from:
I am attending the:
East Coast Convening: Washington D.C., Saturday Nov. 12, 2016
West Coast Convening: Los Angeles Saturday January 20, 2017
Midwest Region Convening TBD
South Region Convening TBD
In 500 words or less, please explain why you're attending this retreat:
Please note: Stipends will be awarded on a case by case basis depending on travel distance and lodging assistance. Stipends will be offered as a reimbursement after the attending the retreat. Please save your receipts and submit hard copies or a scanned photo of the receipts to the Program Manager. Stipends will be awarded up to a maximum of $200.00.
I have read the terms and agreements on the travel and lodging stipend
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service