Name: E-mail:
Street Address: Unit / Apt. #: City, State, Zip
Year of high school graduation:
Yes No
School you attend:
National conventions attended (total number and/or specify years/locations):
Service to NSCL:
Service to state/local SCL:
Please give us an idea of your financial need in attending next year’s NJCL-NSCL Convention:
You may submit an optional letter of recommendation. This is not required. Please submit your application and optional letter of recommendation by July 15 to:
Mr. Jeff Coker 11345 Torino Way Reno, NV 89521
By pressing Submit, you are swearing that the information provided is accurate.
