Summer Short Course Scholarship Application

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. Are you a member of NAPC?

Yes

No

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* 5. If yes, under what name or organization is your membership?

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* 6. Is your commission/community a Certified Local Government?

Yes

No

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* 7. Have you already registered for the Summer Short Course?

Yes

No

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* 8. If you already registered, please provide an address where we can mail your reimbursement in the event that you are awarded a scholarship.