[Nfbk] NFBGL Assistance for Convention

[jayneseif at att.net]

If you wish to apply for Nation Convention assistance via NBGL please fill out and return this form by April 15. 

National Federation of the Blind of Greater Louisville

Request For Assistance 
National Convention 2015

Name 

Address


Phone 
Email

Partial Assistance
Yes No

Full Assistance
Yes No

Are you seeking funding from another source. 
Jernigan Scholarship Fund or KY State

What have you participated in as a member of the NFB?




What would you like to participate in as you continue your journey with the NFB?



Would you like a mentor from your local chapter at the Convention?
Yes  No

Would you be interested in being a mentor at the Convention?
Yes  No

Please note that if you accept assistance you agree to the following. I will attend all General Sessions of Convention 2015. I will attend all Division Meeting that apply to me (Guide Dog Users/ Students/Lawyers/etc.) 

Deadline to apply April 15

Email questions and or applications to jayneseif at att.net

If using print application. Mail to:
Jayne Seif
4805 South 4th St.
Louisville, KY
40214


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