FARA SYMPOSIUM REIMBURSEMENT REQUEST APPLICATION

Name

First

Last

Agency

Email

Phone

Address

City

State/Province

Zip/Postal

Country

Requested Reimbursement(s)

Registration Fee

I certify that I have asked my agency to pay the Registration Fee and that I will be unable to attend the symposium unless the Registration Fee is waived.

Hotel

I certify that I have asked my agency to pay the Hotel Costs and that I will be unable to attend the symposium unless the Hotel Costs are reimbursed.

Airfare

I certify that I have asked my agency to pay for Airfare and that will I be unable to attend the symposium unless the Airfare is reimbursed.

Terms and Conditions

FARA will consider applicant’s request for a one-time symposium reimbursement under the following conditions: • Applicants and Recipients must be Public Safety FARA members in good standing. • Symposium reimbursement funds are limited and will be awarded a first-come, first-served basis according to policies approved by the FARA Board of Directors. • Meals are not included, beyond symposium lunches and breakfasts. • Recipient and recipient agency agree to allow FARA to use their agency name in press coverage or letters to potential donors as applicable. • Award recipients must attend all FARA Training functions (or one of two sessions if they are concurrent) or reimbursement will not be made. On behalf of my agency I agree to the terms and conditions as outlined in this symposium reimbursement application.

Signature- (Type Your Name)