Eligibility

Select all that apply

Greater MN Applicant (Agency outside the counties of Anoka, Carver, Dakota, Hennepin, Ramsey, Scott or Washington)

Currently employed in a crime prevention capacity (LEO, CPS, etc.)

One application per agency

Current MNCPA Member

Has not received the MNCPA Conference Scholarship in two years

Candidate must attend the entire conference

Candidate Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Is anyone else from your agency attending the conference? *

Yes

No

Have you previously attended a MNCPA Annual Conference? *

Yes

No

Acknowledgement

I understand if I am awarded the conference scholarship my registration fee will be covered. It will be my responsibility to cover the cost of the hotel, travel, and any meals not included in the registration fee.