Application for CoDA Service Conference (CSC) Travel Reimbursement Opportunity (TRO)
for Delegates of Voting Entities (VE)
Thank you for taking the time to fill in this application. There are several questions that you may want to consider before you submit the form. We suggest that you consider printing this form and review the information asked for before you submit the form. (A red * denotes a required field.)
This application form applies to CoDA's Service Conference only.
Street Address 2
Phone # (with area code = country code)
If you don't have a phone, enter "none".
Name of Voting Entity
(if you do not have a organized service structure as a Voting Entity, your state or country is the VE)
Voting Entity (VE) Information
VE address 1
VE Address 2
Were you elected by your voting entity as a delegate?
Documentation of appointment by your fellowship groups.
Provide minutes from your VE showing that you were elected/appointed by the VE, or minutes from meetings in the area you plan to represent. In lieu of minutes, provide contact information for meetings that have approved you to represent them at the CoDA Service Conference.
Have you personally received a TRO?
If "Yes", when and for what VE?
Briefly describe what you understand your role as Delegate at the CoDA Service Conference.
Has your VE sent Delegates to the CoDA Service Conference in the past?
I don't know
If known, what years did your VE send delegates to CSC?
Has any delegate from your VE received a TRO to attend CSC?
I don't know
If "Yes", when?
By typing in your name and submitting this form you are
1) acknowledging you have read the accompanying Instructions and Policy (Link:
2) reporting that your information is accurate and truthful to the best of your knowledge.
Send me a copy of my responses
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