CivicLAB 2017 Nomination Form
By completing this form, you approve of the applicant's participation in the CivicLAB 2017 program. This form should be filled out by the applicant's firm principal. Applicants not employed may self-nominate.

You may review the CivicLAB schedule and criteria here: http://www.aiabaltimore.org/civiclab/

CivicLAB Dates (Each held at the AIABaltimore Gallery from 5–7:30pm)
March 1
April 18
May 17
June 21

First Name
Your answer
Last Name
Your answer
Firm Organization/Company
Your answer
Email Address
Your answer
Name of CivicLAB 2017 Applicant (First and Last Name)
Your answer
Statement of nomination (100 words)
Your answer
Will the firm be paying the applicant's $100 tuition?
I authorize and encourage the above applicant to participate in the CivicLAB Program and fully understand the attendance and tuition requirements.
Required
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