2010 Government Trailblazer Program Application

To apply:

1. Download the 2010 Government Trailblazer Application Form Microsoft Word Document
    (click on link or right click and save to your computer)

2. Fill out the application form using Microsoft Word. You may write as much as you need to;     concise responses will be appreciated.

3. Send one double-sided hard copy of the signed application and necessary attachments to:

    National Center for Civic Innovation
    Government Trailblazer Program
     Attention: Nancy Allendorf
    121 Avenue of the Americas, 6th Floor
    New York, NY 10013

    Also, please email an electronic copy of the application to gpr@civicinnovation.org with your     government’s name in the filename.

4. Please send one hard copy and an electronic copy of your latest performance report(s),
    whether internally or externally distributed, with your completed application.

5. Applications Online Now Through: March 15, 2010
    It is to your advantage to submit your application as soon as possible since a limited number of     stipends are available.

If you have any questions or problems downloading this application form, you can reach us at:

     email:
     gpr@civicinnovation.org

    fax:
    (212) 925-5675

    phone:
    (212) 590-9405  Nancy Allendorf
    (212) 590-9413  Verna Vasquez
    (212) 590-9412  Barbara J. Cohn Berman