Application for Chapter Training Grant (Maximum $200 per chapter/per year)

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When you submit this form, a page with the information you entered will display. If you need to make any revisions, click your browser's Back button, then make your revisions and resubmit the form. If all information is correct, print it out and send to:

Walter A. Dobkowski, Chief
NYCDEP
Bureau of Wastewater Treatment
Wards Island, NY 10035

Please attach your program when mailing in this application.

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Applicant Information
Name *
Address *
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Grant Request
Chapter *
Training Date * (enter in m/d/yy format)
Training Location *
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Subject Area *
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Estimated Attendance *
Nature of Expenses *
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Speaker (Honorarium) *
Enter dollar amount
Material, Handouts, etc. *
Enter dollar amount
Meal Subsidy *
Enter dollar amount
Additional Costs
Other costs directly related to training activity
Explanation   
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Total   
Enter dollar amount
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