CivicLAB 2023 Nomination Form
By completing this form, you approve of the applicant's participation in the CivicLAB 2023 program. This form should be filled out by the applicant firm's principal or manager. Applicants may self-nominate.

Sessions may be offered in virtual and in-person format in 2023; from 5:30 pm - 6:30 pm
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First Name *
Last Name *
Firm Organization/Company *
Email Address *
Name of CivicLAB 2023 Applicant (First and Last Name) *
Statement of nomination (100 words max) *
Will the firm be paying the applicant's $100 AIA member/$150 non-member tuition? *
I authorize and encourage the above applicant to participate in the CivicLAB Program and fully understand the attendance and tuition requirements. *
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