Scholarship Application - Colorado Association of Transit Agencies

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Award Information

Application

Agency Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Rural Service Description*

Please provide a brief description of the rural transit service your agency provides. ***Only Public and/or non-profit organizations that provide rural or specialized transportation services, including organizations that receive or are eligible to apply for Federal Transit Administration Section 5310 and Section 5311 current year funds, and other organizations that provide transportation services in rural areas are eligible to apply for and receive funding through the CO RTAP Scholarship Program.

Name of Participants*

First	Last

Enter the first and last name of the Participant(s) receiving the scholarship. Press (+) to add a new entry.

Requester's Name*

First Last

Requester's Email:*

Phone:*

Event Title*

Other Event Title:

Event Date:*

Expenses

Select all that will be use for Scholarship or Match*

Reminder - RTAP scholarships are provided at a 50/50 match (50% scholarship, 50% agency match). Check any boxes below that will be used for scholarship or match. Meals cannot be used for scholarships. However, they can be used for match so long they are not provided by the training event.

Registration
Lodging
Travel
Other

Registration*

Registration Amount $$	Amount Requested for Scholarship $$	Amount Funded by Agency (Match) $$

Lodging*

Lodging Amount $$	Amount Requested for Scholarship $$	Amount Funded by Agency (Match) $$

Travel*

Travel Amount $$	Amount Requested for Scholarship $$	Amount Funded by Agency (Match) $$

Other*

Reminder - meals cannot be used for scholarships. However, they can be used for match so long they are not provided by the training event.

Other Amount $$	Amount Requested for Scholarship $$	Amount Funded by Agency (Match) $$

Please describe Other expenses/match*

Reminder - meals cannot be used for scholarships. However, they can be used for match so long they are not provided by the training event.

Total Expenses*

Total Expenses Amount $$	Total Amount Requested for Scholarship $$	Total Funded by Agency (Match) $$

In accordance with the provisions of the American with Disabilities Act and the Civil Rights Act of 1964, CASTA does not discriminate on the basis of disability, race, color, national origin or gender. For more information about these statutes or to file a complaint, contact CASTA’s Executive Directors at 303.839.5197.

Pre-Event Supporting Documentation

Drop files here or

Max. file size: 256 MB.

Please upload any pre-event supporting documentation such as event agendas, registration, etc. that you may have at this time. You will be required to send additional supporting documents hotel folio/receipt documenting actual expenses paid upon completion of the event. You will receive instructions on how to submit additional documentation in your Award Letter.

RTAP Scholarship Application

Award Information

Application

Expenses

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