2019 Fee Waiver and Travel Grant Application Form 2019 CONFERENCE WAIVER & GRANT APPLICATION 1 General Information2 Fee Reduction/Waiver and/or Grant Request3 Conference Participation4 Application Justification5 Declaration Family Name*NOTE: Please enter here the name that will be used to alphabetize lists of delegates (in most cases “last name” or “surname”).Given Name(s)*NOTE: Please enter here other name or names that, together with your “Family Name” entered above, will be use on the formal list of delegates (in most cases “first” or “personal” name or names).Short Name*NOTE: This should be the name that you wish other delegates to use when addressing you in person (in most cases your “first’ or “family” name, or it could be a “nickname”). Gender*Organization or Affiliation*NOTE: Please enter here the name of the primary organization or institution where you are engaged in justice education activity (university, legal clinic, NGO).Professional Title or Position*NOTE: Enter here your title or position with the organization or institution entered above (professor, director, advocate, researcher, etc.).Country*AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweEmail*NOTE: This email address will be used for all communication regarding the conference, so please enter the address that you use most regularly. NOTE ALSO: You may enter only one email address. This is because your email address will also serve as your identifier for conference management purposes. Enter Email Confirm Email APPLICATION FORM FOR FEE WAIVER/REDUCTION AND/OR TRAVEL/ACCOMMODATIONS GRANT NOTE: The deadline for applying for a travel/accommodations grant is 01 June 2019. This deadline has passed; however, requests for only a fee reduction or waiver can be submitted through 01 August 2019. NOTE ALSO: The general criteria for awarding fee waivers/reductions and travel/accommodations grants are set out on the main conference page in a section titled “Note on applications for fee waivers, fee reductions, and travel & accommodations grants." Type of Application*Fee reduction or waiver onlyTravel and accommodations grant onlyBoth Fee reduction/waiver and travel/accommodations grant Conference participation*Please indicate one of the following optionsI plan to attend only General Conference (4 - 8 Dec 2019)I plan to attend the Full Conference, including Training-of-Trainers Workshop (4 - 10 Dec 2019)Training-of-Trainers Workshop NOTE: The Train the Trainers “TOT” will be held on December 9-10, 2019. The TOT is designed to provide an opportunity for teachers to enhance their skills and to be exposed to a range of teaching methods and tools. This year, the TOT will have two tracks. Participants must select one at the time of registration, either: 1) Implementing Justice Education in Diverse Contexts, or 2) Street Law. Advance registration is required, and registration is limited. Participation is on a first-come, first served basis. Because registration is limited, participants who register are required to attend on both days.Please indicate which TOT track you wish to attend:*Participants may only select one track. Implementing Justice Education in Diverse ContextsStreet LawPresenting at the ConferenceAre you among the presenters in a session proposal that has been submitted (or will be submitted) for this conference?*NoYesTitle of Session*Lead Presenter for the Session*NOTE: If you are the Lead Presenter, please enter your name again Financial Situation and InformationHave you received a fee waiver for past conferences?*Please indicate if you have received a fee waiver (full or partial) to attend 1 or more previous GAJE conferences. Please click NO if this is your first GAJE conference.YesNoWhat percentage of your monthly wage does the conference fee represent?*Less than 25%25% to 50%50% to 75%More than 75%What percentage of the fee will be paid by your employer, home institution, or other sources?*None25%50%75%Have you received a travel grant to attend past conferences?*Please indicate if you have received a travel grant to attend 1 or more previous GAJE conferences. Please click NO if this is your first GAJE conference.YesNoAmount of grant request (in US dollars)*Budget*NOTE please list below an estimated budget of your travel and accommodation expenses (in $US at current rate of exchange).What other sources of financial assistance do you have to help cover your expenses to attend the conference (other than the conference fee)?*NOTE: Please list any and all sources and approximate amount of support.Other sources from which you have sought funds to cover your expenses (including from your home institution) and the amounts sought.*NOTE: If you have already received other support, please list the source(s) and amount(s) of those funds.Please attach a short supporting statement outlining how you meet GAJE’s criteria for assistance to attend the conference.*NOTE: See "Criteria for fee reductions, fee waivers, and grants" on the conference webpage. https://www.gaje.org/2019_conference_home/2019-fee-waiver-and-travel-grants/ You can sign up for GAJE membership online. It is free and available to all persons involved in justice education. Click here Authorization to include name and contact information on List of Delegates*I agree to include my name and contact information on a published List of Delegates (applicable only for delegates who actually attend the conference)I do not agree to include my name and contact information on a published List of Delegates This iframe contains the logic required to handle Ajax powered Gravity Forms.