ICMA / Members / Partners' Program

Partners' Program Application

The Partners' Program feels strongly that attendance at an ICMA Conference has value for both the member and the partner. This financial assistance is available to a partner who has never attended an annual conference, and who must have financial assistance in order to attend.

Contact Information

First Name:
Last Name:
Address:
City:
State:
Zip code:
Phone
Email:*
Occupation (if applicable):
ICMA Member First Name:
ICMA Member Last Name:
Member Position:
No. of Conferences Member attended:
Size of Member's Jurisdiction:
   

Please respond to the following questions:

Tell us about yourself:

Tell us about your Family:

Briefly describe your community:

Areas of contribution

The conference provides common ground for partners to share issues which they have or are facing. Which topic for discussion would most interest you or toward which subject do you feel your experience could contribute:

Expectations

If awarded the stipend, what would be your major expectations? Explain:

Additional Information

This is a needs-based scholarship. To help us consider awarding this scholarship is there anything else about yourself or your situation that you think the Partners' Program should know? If so, include that information:

Criteria for Selection

  • Must be a first-time attendee
  • Must have financial need
  • Partner must be a full member of ICMA
  • Must respond to above questions
  • Must return this form no later than July 31, 2012

Expectations if Scholarship is Awarded

  • Acceptance of this scholarship will require your participation in the 3 Partners' Program events during the conference. Please note, you will be required to return the scholarship money if you are unable to attend the conference and the program activities.
  • Recipient(s) agree to be recognized at Partner events

NOTE: Consideration will be given to applicants from diverse geographical areas and because of cost and distance.