Grant for Continuing Education Programs Application Form

Name of Regional Group or Institutional Member Sponsoring the Program:

 

Name of any additional institutions participating:

 

Name of Contact Person for application:

    Address:

 

    Phone:                                                           

    Fax:

    E-Mail Address:

Name and Address of Payee (should grant be awarded):

 

 

Title of Proposed Program:

 

Program Description (include a description of program format, such as workshop, panel, or lecture, as well as basic content of program):

 

 

Suggested Presenter(s):

 

Qualifications of Presenter(s):

 

Intended Audience:

 

Estimated Size of Audience:

 

Proposed Date and Location for Program:

 

Estimated Program Expenses**

Questions/Comments:

 

 

**PLEASE NOTE. Grant funds may be requested for all types of expenses related to speakers.  If the speaker is a member of the ATLA staff the organization will normally cover related costs. Suggested honoraria are: full day, $400-$450, half day, $200-$250, one- to two-hour workshops, $150-$250. Please explain any deviations from the suggested honoraria in the Comments section above.

Grants are not available for individuals. Grant funds should not be requested for participants' lunch/break food expenses or parking fees. It is anticipated that grant funds may not be available to cover the total cost of a program and that the regional group may need to provide additional funding.

Return this completed form to: