Local Association Grant Request

This form may only be used by local associations to request assistance for attending the AAPL 68th Annual Meeting & Professional Development Land Conference and participating in the Best Practices Education event and networking exhibit area throughout the conference. Mission: Grants awarded by the AAPL Educational Foundation, Inc. (Foundation) are intended to help fund projects and programs that (i) support the American Association of Professional Landmen (AAPL), (ii) promote education, instruction, and training for the members of the AAPL to improve or develop their capabilities, (iii) instruct the public on subjects useful to individuals and beneficial to the community, and (iv) further the advancement of education. Should you have any questions regarding this application, please contact Deanna Young at AAPL, by telephone at: (817) 847-7700 or by email: dyoung@landman.org.

Name of organization to which the grant would be paid

FEIN

IRC section

Mailing Address

City

State Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code

Contact Person

Title

Phone

Email

Project Name

Requested Amount

Other Sources of Funding for Project

Please list the director and president of your local association.

Who will be responsible for managing the local's participation?

Are you or any of your organization's directors, officers and other governing persons in any way affiliated with either the AAPL Educational Foundation, Inc. or the American Association of Professional Landmen? Please choose oneYesNo

Please identify the affiliation. Please choose oneLocal Association AffiliateOther

Name/Signature of Requestor

Date

Nepotism Statement: State law requires applicants to identify any relation(s) to current directors, officers, or employees of either the A.A.P.L. Educational Foundation, Inc. or the American Association of Professional Landmen.