New York State Association Of City And Village Clerks Application For Institute Cmc/mmc Scholarship

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NEW YORK STATE ASSOCIATION OF CITY AND VILLAGE CLERKS APPLICATION FOR
INSTITUTE CMC/MMC
SCHOLARSHIP
YEAR
Name:
Title:
Municipality:
Population:
Address:
Application for (Check One) CMC
MMC
This is my
year of attendance. Have you applied for, or are you receiving any other
scholarship money? Yes ___ No___ If yes, how much and from whom?
Have you previously received a scholarship from NYSACVC?
When?
Are you a member of NYSACVC?
If yes, number of years
Are you a member of IIMC?
If yes, number of years
Date:
Signature:
Optional: To be completed by the City or Village.
STATEMENT OF COMMITMENT
I/We, the
of
. do hereby agree that if
___
is awarded an NYSACVC scholarship, in the amount of
$
, our municipality will assume all additional costs related to his or her
attendance at the IIMC Institute or MMC Academy over and above the scholarship
amount awarded for the year 20
. The cost of the Institute/MMC Academy, including
lodging and meals, is $
. Miscellaneous expenses may be additional.
Date:
Signature/Title:
Scholarship Committee Only: Mark approved or denied and sign off.

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