Arkansas TRIO Policy Stipend Application
AASAP will consider requests from the membership and Arkansas TRIO Alumni for funds related to attending the 2018 Policy Seminar. Please complete the entire form below and submit it by January 16, 2018. Upon review of the submitted requests, the AASAP Board will review requests and notify selected applicants of award amounts.
First Name *
Your answer
Last Name *
Your answer
Are you a TRIO Alumni? *
Institution *
Your answer
Program *
Required
Email Address *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Registration Requested *
Please provide specific amount being requested for registration. Input $0 if nothing is being requested for registration costs.
Your answer
Meals Requested *
Please provide specific amount being requested for meals. Input $0 if nothing is being requested for meal costs.
Your answer
Hotel Charges Requested *
Please provide specific dates and amounts being requested for hotel. Input $0 if nothing is being requested for hotel costs.
Your answer
Other Travel Charges Requested *
Please provide specific details and amounts being requested for travel. Input $0 if nothing is being requested for other travel costs.
Your answer
Applicant's Electronic Signature *
By providing my first and last name below, I commit to fulfill the agreement terms: 1. I will attend and participate in all scheduled 2018 Policy Seminar workshops and meetings designed to prepare participants for congressional visits. 2. I will attend and participate in all of the scheduled visits that have been assigned to me or my congressional visit team. 3. I will work with the AASAP policy team on debriefing activities related to my congressional visits and follow-up activities that will benefit the AASAP membership. 4. I agree that I will repay AASAP the awarded stipend in full, if I fail to comply with the agreement terms.
Your answer
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