Scholarship Program
	APPLICATION FORM
	MICHIGAN CHAPTER OF APCO

First & Last Name: ______________________________________________________________________

Title: ______________________________________ Agency: ___________________________________

Address: ______________________________________________________________________________

City, State, ZIP: _______________________________________________________________________

Phone: (_____) ______________ Fax: (_____) ______________ # of Years in Public Safety: _______

How will attending this Conference benefit you as a 911/Public Safety professional?
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How will this Conference Benefit your agency or County?
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Briefly Describe your current responsibilities:
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I understand that the basis for the scholarship is financial need.  I hereby make application to MI-APCO for a scholarship on the inability of my agency or county to pay the full cost of attending the MI-APCO Fall Training Conference.

Applicant Signature: ______________________________________________________ Date: ______________________________

Agency Official Signature: __________________________________________________ Date: ______________________________

Please return this completed application by August 24, 2008 to: 
MI-APCO Scholarship Fund,   c/o Karen Chadwick, Lansing/Ingham 911 Center, 120 W Michigan Avenue Lansing, MI 48933 or fax 517 483-4824.

Scholarship Application Rules	Fall Conference
Conference Registration	APCO Newsletter
Program Schedule	Michigan APCO Main Page
Session Descriptions
Participating  Vendors

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