2018 Diversity Registration Waiver and Travel/lodging Scholarship Application for those awarded Registration Waivers
REGISTRATION WAIVERS

Diversity and Registration waivers cover the meeting registration fee only. If you receive a waiver, you will still need to cover your lodging, food and travel unless you also are approved for a scholarship.

You will be notified of a registration waiver no later than 10 days after you apply.

Last Name *
Your answer
First Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
ZIP *
Your answer
Home Phone
Your answer
Other Phone
Your answer
E-Mail Address *
Your answer
GPUS Committee Activity
Your answer
Local/State Green Party Activity
Your answer
Name/Phone/Email Reference *
(Someone that can attest to your GP activity)
Your answer
Are you a GNC Delegate/Alternate?
Your answer
Please list any other green activism or Green Party work not listed above.
Your answer
Have you ever attended a Green Party national meeting?
Your answer
If yes, when?
Your answer
Have you previously received a GPUS Diversity Committee fee waiver or travel and lodging subsidy?
Priority will be given to people who have not received this waiver in the past.
Your answer
Arrival date
Departure Date
Name/phone/email for reference
Someone that can verify your green party involvement
Your answer
Caucus eligibility *
You do not have to be a member of a caucus but you must be eligible to be a member.
Delegate status
Are you a National Delegate/Alternate or PNC Delegate/Alternate - check all that apply
State/Local Party involvement
Check all that apply
Have you attended a prior Annual Meeting or Presidential Convention. If so, what was the last meeting attended.
Your answer
Please briefly describe what you hope to gain by attending the 2017 ANM.
Your answer
Where will you be staying?
Total - estimated housing cost (housing in residence halls is $42 per night for a single room with a shared bath)
Are you willing to share a room?
How will you travel?
Estimated total travel cost
Estimated food costs (estimate at $30 per day for Thursday and Friday and $20 for Saturday)
Total estimated meeting cost (food, lodging, travel) (not including registration)
Your answer
How much do you expect to contribute to the meeting cost?
You are encouraged to contribute at least 20% - more if possible.
Your answer
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