Tuition Assistance – NYCLA CLE Institute

Full Name *

Address *

Address

City

State/Province

Zip/Postal

Phone *

Fax

Email *

Number of years that you have been licensed to practice law *

Will your attendance at this course be applied toward required MCLE credit requirements? *

Yes

No

Please indicate state(s) *

Are you a member of NYCLA? *

Yes

No

Course applied for *

Enter full name of the course as listed on CLE Calendar

Date of course *

For which state(s) are you seeking MCLE credit? *

New York

New Jersey

Connecticut

Not applicable

Lowest advertised tuition applicable to you: *

$

Enter number only

Statement of relevance of course to your practice *

AFFIRMATION OF EMPLOYMENT, INCOME, NEED FOR SCHOLARSHIP
and Tuition You Can Afford to Pay

I affirm the following information to be true:

(a) Employment Status *

Employee of a not-for profit or Public Interest Attorney (list employer)

Legal Aid staff attorney or Public Defender

Local, State of Federal Government Employee (list employer)

Employee of a law firm (list Employer and number of attorneys)

Solo Practitioner

Law Student

Unemployed

OtherOther

Employer Name/Number of Attorneys *

Law Students, enter Law School.

(b) Yearly income *

$

Enter number only

(c) Explanation of Need for Scholarship *

(d) Highest tuition you can afford to pay *

$

Enter number only

Date *

Signature *

Clear