GREATER CINCINNATI AOSA CONFERENCE ASSISTANCE FUND APPLICATION Page 1
(Only TYPED and COMPLETE applications will be accepted.)

PART I

NAME DATE

ADDRESS CITY STATE ZIP

PLACE OF EMPLOYMENT

BUSINESS PHONE ( ) HOME PHONE ( )

EMAIL:

PURPOSE OF GRANT: AOSA National Conference Registration LOCATION

AMOUNT REQUESTED: $250.00 For Conference Registration ( with up to $500. additional for Travel, Lodging, and Meals with Verified Receipts )

AOSA member? How long (student membership may be included)?

Are you a member of an AOSA local chapter?

Which one?

How Long?

PART II (May use own form)

PROFESSIONAL EXPERIENCE: (List most recent first include job title and dates of employment)

EDUCATION: (List most recent first. Include dates, degrees attained, and specialized Orff teacher training.)

OTHER PROFESSIONAL ACTIVITIES: (Professional Associations, Performing groups, etc.)