[CPEO-BIF] Environmental Justice Conference -- Financial Assistance Application

Please post the attached notice on your list.

Thanks,

John

State of Environmental Justice in America 2007

Howard University School of Law

2900 Van Ness Street, NW

Washington, DC

March 29-31, 2001

Financial Assistance Application

A limited amount of financial assistance funds for travel, on a reimbursable basis, is available for conference participants. Funding will be approved based on available funds, equitable distribution, a ?first come? basis, and awarded according to the guidelines below.

Available Technical Assistance Funds:

Hotel: 2 nights - 100% based on double occupancy.

Transportation (air, train or bus): round trip coach; full fare

Automobile Mileage: Maximum per organization is $400 (actual miles round trip from home to Washington, DC).

Conference registration: Includes continental breakfast on Friday and

Saturday; lunch on Friday; Evening receptions on Thursday and Friday. Lunch on Saturday.

Conditions for receipt of funding:

1. You must attend all three days of meetings (no funding will be provided to persons not attending the entire meeting);

2. Your completed application must be received by 5:00 PM (Eastern) Friday, February 9, 2007.

3. You must provide your original receipts and completed reimbursement form for travel and lodging. The reimbursement form and original receipts must be received by May 31, 2007. Please mail them to EJConference2007 1717 K Street, NW , Suite 600, Washington, DC 20036.

Name______________________________________________________

Last First Middle

Address____________________________________________________

(Street) (City) (State) (Zip Code)

Telephone ( ) _______________Fax ( ) _______________________

E-mail Address_______________________________________________

Organization_________________________________________________

Role in Conference: (i.e., Oral Presentation, Poster Presentation, Moderator, Panel Participant, etc.)________________________________

Which level of scholarship are you applying for?

Full_____ Registration (includes workshop materials, meals, and up to 2 nights lodging, and air fare or mileage).

Partial____ Registration (includes workshop materials, meals and mileage).

Other (Please specify)_____________________________________________

Privacy Notice: The information gathered on this form is intended solely for the use in connection with the State of Environmental Justice in America 2007 Conference. All information obtained through this registration form is kept confidential and will not be shared.

Signature: _________________________ Date: ________________

I understand that my signature on this application indicates my acceptance of the conditions for receiving financial assistance funding for travel.

IMPORTANT DEADLINE SUBMISSION INSTRUCTIONS:

Please submit your completed application to the following locations:

Email Address: ejinamerica2007@yahoo.com

Suggestion: Send using return-receipt email confirmation.

EJ Conference 2007

ATTN: John Rosenthall

1717 K Street NW Suite 600

Washington, DC 20036

Suggestion: Send by Certified Return-Receipt to Ensure Delivery Confirmation.

Your application must be received no later than 5:00 PM (Eastern) Friday, February 9. 2007. Applicants will be notified of selection by Friday, February 23, 2007.