CCL Conservative Scholarship Application
Sign in to Google to save your progress. Learn more
Untitled Title
Full Name
Phone Number
Street, City, State, Zip Code
Political affiliation
Clear selection
Clear selection
Are you a student?  
Clear selection
Will you be over 18 at the time of the conference?
Clear selection
CCL chapter (if applicable)
Why would you like to attend the June International Conference and Lobby Day?
What is your background or involvement in CCL?
How are you engaged already on the issue of climate change?
What experience do you have organizing or being active with conservative groups?
Are you applying for a $500 or $250 scholarship?
Clear selection
What are your estimated travel and lodging expenses?
How do you anticipate using the conference/lobby day experience after you get back home?
We would like you to have the support* of a CCL leader in your area. Which Group Leader, State Coordinator, or Regional Coordinator is supporting you and your application? (If you need help connecting to a GL/SC/RC, email
By support we mean approving your application and planning to follow up with you after the conference to talk with you about your next steps as a climate advocate.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Citizens' Climate Education. Report Abuse