NEW YORKSTATETOWN CLERKS ASSOCIATION
APPLICATION FOR SCHOLARSHIP GRANT - 2018
The New York State Town Clerks Association (NYSTCA) is offering scholarships for attendance at the 2017 NYSTCA Conference in Albany from April 22- 25, 2018.
A minimum of 7-$400 scholarships and 1-$500 Margaret Lamore Scholarship will be awarded.
Mail, email or fax applicationto: WayneH. Wink., Jr., Scholarship Chair, Town of North Hempstead,200 Plandome Road, Manhasset, NY 11030, Fax 516-627-1714. Questions?? Call 516-869-7647 or email .
Deadline for applications to be received isFebruary28, 2018
Scholarship RecipientsMUST ATTEND ENTIRE CONFERENCE for the scholarship to be awarded.
Name: ______
Title: ______
Mailing Address: ______
Town______Telephone______Fax______
Email______
County______Population______Length of time in office______
Previous offices(s)/service related position(s) held and dates:
______
Are you a member of NYSTCA? ______Dates(s)______
Have you attended prior conferences?______Dates (s)______
Related organizations to which you belong______
Prior education:
NYSTCA______Association of Towns______
IIMC______CountyTown Clerks Assn.______
Other______Are you an RMC?_____ What year?______
Dues for organizations paid for by: (List amount and organization)
Town______Yourself______
Other (specify)______
Does your Town Board currently allow or have previously allowed, educational expenses to you or other Town Officials?______
Explain actual financial expenses for education for the past 2 years: (List year and amount) i.e. 2016/$75. Please attach details
NYSTCA______IIMC______
Association of Towns______County Town Clerks Assn. ______
Other______
Current and previous budget allowances for education: Attach details
NYSTCA______IIMC ______
Association of Towns______County Town Clerks Assn. ______
Other ______
Include itemized travel and educational expenses for the current and two previous years.
NYSTCA ______IIMC ______
Association of Towns______County Town Clerks Assn. ______
Other ______
Have you previously applied? No Yes Award No Yes Yr/yrs ______
Brief description of why you are applying and need this scholarship:
______
All applicants' sign below. Please have the Supervisor complete the appropriate statement below on behalf of the Town Board indicating rather or not your Town will assume the balance of your costs for attendance at the NYSTCA conference.
I, ______Supervisor of the Town of ______
and behalf of the ______Town Board do hereby agree to assume all costs over and above the amount of the NYSTCA Scholarship Grant related to attendance of the ______Town Clerk at the 2017 NYSTCA conference. I also understand that membership in the NYSTCA is required in order to receive any scholarship.
Or
The Town of ______will not be paying the cost of attendance of the ______Town Clerk at the 2017 NYSTCA conference.
Signature of Applicant ______Date ______
Signature of Town Supervisor ______Date ______
Each applicant will be notified no later than March 15th with the results of the Scholarship Committee awards.