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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