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AACAP Advocacy Day
                                       May 10-11, 2012


                          Resident Travel Grant Application
With the support of AACAP’s Campaign for America’s Kids, AACAP is providing travel grants of
$250 to child and adolescent psychiatry residents to attend Advocacy Day. These travel grants must
be matched with support from your regional organization. Regional organizations can select up to
two residents to support. The scholarships will be awarded on a first-come-first served basis.

  All applications must be submitted with a letter of support from your regional organization
                         president, acknowledging matching support.

Name: ________________________________________________________________

HOME Address (where you vote):

______________________________________________________________________

City: ____________________________ State: ___________ Zip Code: ___________

Phone #: ______________________ Email: __________________________________

Regional Organization: ___________________________________________________




I will ___ will not ___ attend the Thursday afternoon Advocacy Training.

I will ___ will not ___ attend the Thursday evening Reception.


             The deadline for applications is April 13, 2012.
    Please submit all materials to Liz DiLauro at edilauro@aacap.org
                         or fax to 202-966-1944.



              This program was made possible by a grant from the American Academy of Child and
                            Adolescent Psychiatry’s Campaign for America’s Kids.

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Resident Travel Award Application for AACAP Advocacy Day

  • 1. AACAP Advocacy Day May 10-11, 2012 Resident Travel Grant Application With the support of AACAP’s Campaign for America’s Kids, AACAP is providing travel grants of $250 to child and adolescent psychiatry residents to attend Advocacy Day. These travel grants must be matched with support from your regional organization. Regional organizations can select up to two residents to support. The scholarships will be awarded on a first-come-first served basis. All applications must be submitted with a letter of support from your regional organization president, acknowledging matching support. Name: ________________________________________________________________ HOME Address (where you vote): ______________________________________________________________________ City: ____________________________ State: ___________ Zip Code: ___________ Phone #: ______________________ Email: __________________________________ Regional Organization: ___________________________________________________ I will ___ will not ___ attend the Thursday afternoon Advocacy Training. I will ___ will not ___ attend the Thursday evening Reception. The deadline for applications is April 13, 2012. Please submit all materials to Liz DiLauro at edilauro@aacap.org or fax to 202-966-1944. This program was made possible by a grant from the American Academy of Child and Adolescent Psychiatry’s Campaign for America’s Kids.