2017 Statewide Conference Scholarship Application

2017 Statewide Conference Scholarship Application

Transformative Conversations: Think Differently to End Sexual Violence
Please note: There are no longer hotel rooms available at the state rate for CALCASA's Statewide Conference. Travel scholarships are still available, however, CALCASA can only reimburse for lodging up to the state rate. The remainder would need to be covered by the applicant through a funding source other than Cal OES.

CALCASA’s 2017 Statewide Conference will be held on August 7-10, 2017 at the DoubleTree by Hilton located at 2001 Point West Way in Sacramento. This year’s theme is “Transformative Conversations: Think Differently to End Sexual Assault.” Pre-conference events will be held on August 7-8, 2017 and the Statewide Conference will held on August 9-10, 2017.

With the support of the California Governor’s Office of Emergency Services (Cal OES), CALCASA is able to offer limited travel scholarships to attend the 2017 Statewide Conference. Scholarships are given out on a reimbursement basis and will only cover primary form of travel and/or up to 4 nights of lodging. Scholarships will not cover parking, per diem, or baggage fees. Scholarships are limited so please fill out the application as soon as possible.

Scholarship eligible expenses:
- Primary form of travel (i.e. Airfare, Amtrak) or mileage if traveling by car.
  - We ask that participants find the most economical form of travel.
  - Mileage is reimbursed at $.535 per mile and a Google map is required when requesting reimbursement from agency office to the DoubleTree.
- Lodging (up to 4 nights) at the DoubleTree offered at the CA Government rate of $95 per night plus tax.
  - Lodging will be reimbursed only to attendees whose agency is more than 50 miles away from the conference site (DoubleTree Hotel).
CALCASA may award travel scholarships at an amount less than the estimated costs. Each scholarship recipient will receive a cap on the amount of expenses that will be reimbursed.

CALCASA will notify all scholarship applicants who submitted applications by June 23, 2017. Any application submitted after June 15, 2017 will be awarded only if funding permits.

Scholarships are limited to California Residents (or employees of California agencies).

Applications are due on June 15, 2017 by 11:59 pm PT.

Please Select One Type of Scholarship Requested:*

Applicant Information
Applicant's Name*

First NameLast Name
Agency Name*
Agency Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of ED/Supervisor*

First NameLast Name
Phone Number*

Area CodePhone Number
Extension
Fax Number

Area CodePhone Number
Start Date

MonthDayYear
End Date

MonthDayYear
E-mail*

Expenses

Estimated Conference Expenses*

	Estimated Cost
A) Travel (Airfare, Amtrak)
B) Lodging at the Double Tree Hotel is set at the California government rate of $95 per night plus applicable taxes and fees. Please estimate number of nights x’s $110 per night.
C) Mileage (round trip from agency to conference site). Please estimate number of miles x $0.535

Total Estimated Conference Expenses
Provide back up information for estimated travel costs (i.e., airplane tickets, train ticket price, Google map)

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2017 Statewide Conference Scholarship Application

Applications are due on June 15, 2017 by 11:59 pm PT.