APPLICATION FOR CONTINUING EDUCATION SPONSORSHIP

MEMBER NAME ___________________________Date___________________

Address __________________________________________________________

Title of Educational Opportunity

_____________________________________________________________________________________________________

Brief description of class, meeting, or activity, including date, location, presenting organization to whom sponsorship check will be made. NOTE: PLEASE ATTACH BROCHURE, NOTICE OR COPY OF EDUCATIONAL OPPORTUNITY INFORMATION TO THIS HAGC FORM.

______________________________________________________________________________________________________

________________________________________________________________________________________________________

Application Denied: ______________ Reason____________________________

Application Approved_____________ By:______________________________