Conference Scholarship Application
2017 ACR-GNY Financial Scholarship Application

Requests for reduced or waived fees for ACR-GNY's 16th Annual Conference can be made on this form and submitted at least 2 weeks prior to the conference date, June 15th, 2017. ACR-GNY reserves the right to exercise discretion in the approval of the scholarship. Scholarship awards are not transferable.

Scholarships may be granted to individuals with a gross annual income of less than $35,000. ACR-GNY reserves the right to grant or deny scholarships regardless of gross annual income and subject to the criteria set forth in the application.

First + Last Name
Your answer
Email Address
Your answer
Phone Number
Your answer
Are you an attorney?
Are you seeking CLE credit?
Please indicate the amount you are able to pay towards the conference fee.
Your answer
Please describe the basis for your need for a scholarship.
Your answer
Please describe your interest in attending the conference.
Your answer
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