Deadline for application is  January 15, 2004

Applications should be mailed or faxed to:

 

Mary Kelly Mueller

Director of Youth Ministry

300 E. 36th Street

Kansas City, MO 64111

Fax: (816) 756-0878

E-mail: mueller@diocesekcsj.org

 

Recipients will be notified by  February 1, 2004

 

 

 

Name                                                     

 

Address                                                     

 

City/State/Zip                                                

Telephone (Day/Evening)                                         

 

 Email Address                                                 

 

 

Parish Affiliation                                             

 

Name of Parish Contact                                          

 

Address/Phone for contact                                        

 

Area of ministry or interest                                        

 

 

Please indicate your reasons for wanting to attend the Heartland Conference, and why you are choosing to apply for financial assistance.  Attach a separate sheet if necessary.

 

The conference registration fee is  $150.00.  Assistance is available up to $75 per registrant.  

Amount of assistance you are requesting:  $                 

 

Signature                                    Date             

 

Disclaimer:  Distribution of awards is based on the availability of funds. 

Assistance will be awarded on a case by case basis.