2007 NCLR Líderes Summit Application for Financial Support

The National Council of La Raza (NCLR) is pleased to announce the availability of financial support to groups who wish to attend the 2007 Líderes Summit and NCLR Annual Conference in Miami, Florida, July 20-24, 2007.

NCLR will make every effort to assist individuals who request financial support, but due to limited funds we cannot guarantee that all requests will be fulfilled. Also, please note that based on our selection process, an applicant may be awarded less than the original amount requested.

In order to qualify for financial assistance, applicants must have raised (50%) of their total costs through other means - NCLR will only award up to half (50%) of overall participant expenses (registration, travel, housing, etc.). For example, if expenses total $1,000, then the applicant must have raised at least $500 on his/her own to be eligible for the maximum award.

In addition, NCLR will only provide a maximum award of up to $600 per individual participant, and up to a total maximum of $3,000 per group application. Please be conservative with budget estimates. NCLR financial assistance is not guaranteed, and if your application is accepted, you may be offered an amount less than the total you requested.

NCLR will make award decisions based on budget submitted, number of people in the group, fundraising efforts, and affiliate and/or prior Líderes Network membership, as well as on geographic and other diversity. Finally, groups who have not received other forms of financial assistance (e.g., discounted hotel rooms, free registrations for workshop presenters) will receive first consideration.

All selected applicants will receive written confirmation of their award. If financial aid is awarded, all participants must commit to attending ALL Summit activities. Failure to attend any Summit events can result in the forfeit of awarded financial support funds. Financial support will be in the form of reimbursement after NCLR receives receipts and/or appropriate expense documentation in a timely basis.

All applicants must be Líderes network members. If your group/organization is not currently a Líderes Network member, please be sure to check the box on the following page to request addition to the Líderes Network.

TO APPLY

To apply for financial assistance from NCLR, please fill out and submit the attached application form to dpernick@nclr.org or fax to (202) 776-1796 Attn: Denise Pernick

Applications MUST BE RECEIVED by Friday May 11, 2007

2007 NCLR Líderes Summit

Application for Financial Support

(Please email completed application to dpernick@nclr.org or fax to (202) 776-1796 Attn: Denise Pernick by Friday, May 11, 2007)

Contact Person:

Title or Position:

Organization/Program Name:

School or Institutional Affiliation:

Address:

City: State: Zip:

Phone Number: E-mail:

Our Group is:

An NCLR Affiliate

A Líderes Network Member

Presenting a Workshop at the 2007 Líderes Summit

Receiving Discounted Hotel Rooms (at the Miami Marriott Biscayne Bay Hotel)

Note: If your group is not currently a Líderes Network Member please check here to join the Network:

Total Number in Group Attending the Summit:

# Youth (ages 14-25) and # Adults (chaperones, advisors, etc.)

Names of all people attending:

(Note: include ages of all youth)

(Add paper if necessary to list all attendees)

Arrival Date: Arrival Time:

Departure Date: Departure Time:

In Miami we will stay at (Hotel Name):

2007 NCLR Líderes Summit

Application for Financial Support

I, , representing (group), do hereby attest that all of the above-named individuals commit to participating in all Líderes Summit activities. I understand that I am assuming responsibility for informing the group of this commitment, and hereby acknowledge on the entire group s behalf that if funds are awarded, failure to comply with attendance rules can result in forfeit of those funds.

Signature Date

For more information, please contact Denise Pernick at (202) 785-1670 or via email at dpernick@nclr.org

2007 NCLR Líderes Summit

Application for Financial Support

Estimated Costs Worksheet (Use this form or your own. Please provide as much detail as possible.)

Item Cost

Registration $250/participant X participants $

Travel Mode of transportation:

Cost per ticket: $ X participants or Estimated transportation expenses (van rental, etc. - describe):

$

Hotel (Entire Summit is 6 nights, Thu., July 19 Wed., July 25)

$ /night X rooms X nights $

Food (2 dinners on your own during Conference)

$ per meal X participants x 2 meals $

Other Costs

Describe:

$

$

Total Costs: $

Total Funds Raised: Sources and Amounts:

$

__________________________________________________________ $

TOTAL FUNDS REQUESTED: $

ADDITIONAL INFORMATION (Describe your fundraising efforts, and/or explain any special circumstances about your application. Attach extra pages if necessary.)