Phone/ Face to Face Meeting GSR, ISR, GSB

WSC 2012 Friday, August 17 thru Sunday, August 19

Attendance Stipend Application Form

Phone/ Face to face Meeting GSR, ISR, GSB

Meeting Name
GSR/ISR/GSB Name
Contact No/Email
*Have you informed your U/A meeting of your intention to apply Yes/No
[If no- STOP- and please inform your meeting, remember these are 7th tradition funds]
*Amount applied for up to a max- $250…
*Reason
Funds can be applied to ANY cost of attendance,
Would you be willing to offer help at the conference?
Do you need any special assistance at the conference itself – yes/no
Do you have any special dietaryrequirements? E.g., Halal, Kosher, Vegetarian, Vegan (Y/N)
Spending plan
Item 1/amount
Item 2/amount
Item 3/amount
Total applied for
*If funds are given in advance, they must be returned in the event of non attendance
I agree to the terms/conditions- Yes/No
I have rechecked my figures and they add up! -Yes/no
Date form prepared
Anything else we should know to support your application?
How do you wish to be paid? -Please give *details
*Your details will not be shared
Your Email /phone no (again)

FAQ.

Do I qualify-? If you are a GSR, ISR or GSB member you may apply regardless of location.

Do I have to use it for Travel? -NO- this stipend is to assist in your costs of attendance, whatever those are…INCLUDING childcare, phone calls into conference line, mobility attendance,presence of medical caregiver at conference, etc,

I need Help filling out this form/I have difficulties with the internet/can’t use email/Am confused/Dyslexic/. Etc –Please call Bella (518) 282-4525

How do I get paid? -Preference is for payment at the WSC by check, but if you require cash please indicate this on your form, likewise you can be paid via PayPal.

What if I need to be paid in advance is this possible? – Yes Please indicate this clearly on your form. You may get a phone call/email asking to confirm details and reasons

What proof do I need to show of my expenses?–A Simple spending plan on the form in the first instance…if approved then someDocumentation/simple receipts either at the conference or before.

How will I know if I have been awarded a stipend? A phone call or an email. Will be sent. Please recheck your details on the form are correct and that your numbers add up!

Will I have to break anonymity to get the funds? -NO, not necessarily but be aware you must be known to the your group in some form.

How do I know my details will not be shared and my anonymity will not be broken by U/A if I include my real name? - We won’t,promise.

Where is my Money? - Where is your form? Be sure you sent it; acknowledgement will be sent on receipt of your application

Why was my application turned down, I really need to be there? - Possible reasons -Form filled incorrectly, you don’t qualify, it was received too late, we could not contact you to clarify something,we ran out of funds. Remember you can also listen in on

UALine3 (712) 451 6000 Access 250779#

Please only apply for as much as you need up to $250 MAX.

RETURN FORM TO EITHER

Thanks for you application and good luck.