National Judges' Education & Research Foundation
Scholarship Application
PLEASE DO NOT OMIT ANY INFORMATION!

NAME
FIRST
MI
LAST

TITLE 

COURT 

COURT ADDRESS
STREET, PO BOX
CITY
STATE / ZIP

TELEPHONE
FAX
EMAIL

HOME ADDRESS
STREET, PO BOX
CITY
STATE / ZIP
ARE YOU: Full Time Part Time Hours Per Week 
TYPE OF COURT Check all that apply:
Special Court Limited Broad Jurisdiction
Justice Court Municipal Court Other:
Civil Jurisdiction  $ Misdemeanors Felonies
Juvenile Probate Jury Trials Traffic
Family Court Ordinance Violations
POPULATION YOUR COURT SERVES:
 HOW MANY JUDGES?
PURPOSE OF SCHOLARSHIP APPLICATION:
  Attend Class at National Judicial College
If so, provide specific information on class subject and date:

OR
  Conference registration fee for NJA annual Education Conference
MEMBER OF NATIONAL JUDGES ASSOCIATION since:


MUST BE FILLED OUT
HAVE YOU EVER RECEIVED A SCHOLARSHIP FROM THE FOUNDATION?
NO YES
If yes, when, & for what purpose:
FUNDING AGENCY:
NAME
ADDRESS
QUESTIONS? To get answers or to submit application, Contact your state director, a board trustee, or:

National Judges Education & Research Foundation
Hon. Candace Hissong, chair
PO Box 325, Glendale, OR  97442
Telephone:  541-832-2101  Fax:  541-832-2102
Email:  chissong@co.douglas.or.us or bobcan@tymewyse.com