Home>Application for Annual Grant: Grant Year 2013
TO APPLY: Fill out this form and submit it by midnight on December 31, 2012. If you have any questions, please contact
Please provide your employer's information in the field of public interest law, including Name, Phone Number and Address.
Please describe briefly the nature of the work you expect to do for your employer in the field of public interest law.
If you or a member of your household will owe substantial debt, other than qualified debt, during the grant year, list below the nature of the debt and the amount that must be repaid during the grant year. Please include: 1. Nature of Debt, 2. Total Amount, 3. Amount that must be repaid during the grant year for each item you list.
If your household will have income other than your income and your spouse's income during the grant year, list the income below. Please include: 1. Nature of household income, 2. Amount of household income for each item listed.
If you are receiving loan repayment grants or any other sort of loan repayment assistance from your employer or any other sources, please indicate those below. Please include: 1. Source of Loan Repayment Assistance, 2. Amount of Assistane (Annually) for each item listed.
Select the option below that most accurately reflects the total value of assets that you and members of your household will own during the grant year, including home equity, bank accounts, securities, etc.
If you will be responsible during the grant year for the living expenses of persons in your household other than yourself, enter the number of such persons here.
Describe briefly the connection between your expected employment in the field of public interest law and your long-term career goals.
Describe briefly any activities that demonstrate your prior commitment to public service.
Describe briefly any features of your law school career that you believe should be considered in evaluating your application, including academic performance, courses taken, co-curricular activities, extracurricular activities, etc.
Select the statement below that most accurately reflects your current career plans.
Charter of the Loan Repayment Assistance Program of the University of Georgia School of Law
Please sign this form using your initials.
Please provide today's date.