Please send your completed application to Chair, Grants & Scholarships Committee, Linda C. Dean, Nixon Peabody LLP, Fax (866) 743-2146 

ALLUNY ERNEST H. BREUER AWARD APPLICATION 
One grant in the amount of $250 will be awarded to a member to attend the ALLUNY annual meeting.

Name: 

Organization: 

Position: 

Address: 

Phone: 

Fax: 

E-mail address: 

How do you feel you will benefit from attendance at this meeting? 




Beginning with your current position, please list your last 3 positions, your place of employment, job title and length of service: 




Years of ALLUNY membership: 

Have you previously attended ALLUNY meetings? 
If yes, when? 



Describe your participation in ALLUNY. (Please list office(s) held, committee participation or other activities.) 




Will your employer pay any or all of your expenses to attend this meeting?  
If so, please state how much: 


Have you previously received an ALLUNY grant/scholarship?   
If so, please state the amount, year and purpose of award:   
 


If I receive an ALLUNY award, and if for any reason cannot attend, I am required to inform the 
ALLUNY Grants Chairperson as soon as possible. In addition, I understand that recipients are required to write a brief article for the ALLUNY Newsletter summarizing the meeting/sessions attended which is to be submitted to the Editor for inclusion in the issue immediately following the meeting date. 



Applicant's signature 				Date 





Please send your completed application to Chair, Grants & Scholarships Committee, Linda C. Dean, Nixon Peabody LLP, 1100 Clinton Square, Rochester, NY 14604. Fax (866) 743-2146. Telephone (585) 263-1398. Email: ldean@nixonpeabody.com. 
Thank you.