CivicLAB 2022 Nomination Form

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By completing this form, you approve of the applicant's participation in the CivicLAB 2022 program. This form should be filled out by the applicant firm's principal or manager Applicants may self-nominate.

Monthly sessions will be offered virtually in 2022; from 5:30 pm - 6:30 pm

First Name *

Last Name *

Firm Organization/Company *

Email Address *

Name of CivicLAB 2021 Applicant (First and Last Name) *

Statement of nomination (100 words max) *

Will the firm be paying the applicant's $100 AIA member/$150 non-member tuition? *

Yes

I am self nominating

I authorize and encourage the above applicant to participate in the CivicLAB Program and fully understand the attendance and tuition requirements. *

Yes

Required

Submit

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