Use this form to apply for a CAAO Scholarship (not available for UCONN).  Send to the Professional Designation and Awards Committee Chairperson or any other member. 

SCHOLARSHIP APPLICATION - C.A.A.O.

PROFESSIONAL DESIGNATION AND AWARDS COMMITTEE

Name:____________________________________________________________________________

Mailing Address:____________________________________________________________________

Employing Municipality:__________________________________Work Phone #:_________________

COURSE INFORMATION

Course Name:____________________ Course Sponsor: ________________ Course Cost $________

Location of Course:_________________________________________    ATTACH PERTINENT

                                                                                                                    COURSE INFORMATION

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ATTACH REFUSAL TO PAY LETTER FROM YOUR MUNICIPALITY

By my signature, I certify that I am a member in good standing of the C.A.A.O.

Signature:___________________________________________  Date:____________________