The Karen McQuillan Memorial Fund Application Form

The Karen McQuillan Fund, honoring RESULTS’ first Domestic coordinator, was established in 1998 to assist low-income RESULTS U.S. partners to participate fully in RESULTS activities. For the International Conference, assistance with fees, lodging, travel, and related costs is offered. The goal is to provide support for those who would otherwise be unable to participate due to costs. Every effort is made to distribute resources as fairly and equitably as possible.
Funds are extremely limited.Please submit your applications as soon as possible. Early application will also allow us to secure the lowest transportation costs (so more people can benefit from the Fund) and make it more likely you will be funded. Financial assistance will be distributed on a first come, first serve basis.
** The priority application deadline is April 9th. The late submission deadline is June 15th.**
Return to:Allison Burket, RESULTS Educational Fund, 1730 Rhode Island Avenue NW Suite 400 Washington, DC 20036. (202) 783-7100 FAX: (202) 466-1397; e-mail:. For more information, call: (202) 783-7100 ext. 114

To Apply:

  1. You must be low-income and an active RESULTS volunteer in the United States. Contact Allison Burket if you are unsure of whether or not you are eligible for the Karen McQuillan Fund.
  2. Fill out the following questionnaire in complete detail. (Feel free to type your application on a separate sheet or send it by e-mail but make sure you answer all the questions.)

Your Name:______

Address:______

City:______State: ______ZIP: ______

Phone: (home)______(work) ______

Fax:______E-mail ______

RESULTS Group:______Check one: Global ___ Domestic ___

Emergency contact (for registration purposes) Name: ______Number:______

1) What are your current roles and activities in RESULTS?

2) What is something you are most proud of through your participation in RESULTS?

3) What benefit do you think you and your group will receive from your attendance at the conference?

4) What RESULTS conferences have you attended before? Never attended ____

5) If you have attended a RESULTS conference before, what has been the impact of them/it on your RESULTS experience?

6) What do you plan to take away from the RESULTS conference?

7) Have you received support from the McQuillan Fund in the past? ___ Yes ___ No If yes, for what?

8) How much are you yourself able to contribute to fund your attendance?

9) What other efforts have you made or are you planning to make to support your attendance?

10) Any other comments?

Estimated Costs:

On the chart below, estimate your costs: / On this chart, fill in what you are requesting from the Karen McQuillan Fund:
Registration / $______/ Registration / $______
Meals* / $______/ Meals* / $______
Travel / $______/ Travel / $______
Hotel / $______/ Hotel / $______
Other (Explain)** / $______/ Other (Explain)*** / $______
Total / $______/ Total / $______

Comments/Explanations:

Registration costs: $250, standard rate (First Time/Student Attendee: $175)

Meals: The McQuillan Fund generally will fund $20–25 per day for food.

Room Rates at the DoubleTree by Hilton Hotel– Crystal City (300 Army Navy Drive Arlington, VA, 22202): Rates include taxes and hotel charges.

1 person in room — $170.5/person per night2 people in room — $85.25/person per night

3 people in room — $64.17/person per night4 people in room — $53.63/person per night

** Under “Other,” you might include costs of ground transportation to and from the airport. Metro (public transit) costs are around $2.50 to $4.50 per trip. Costs from Dulles and Baltimore airports can be greater. Call the office at (202) 783-7100 for more details or see the transportation information on the RESULTS website.

If you have questions, call Allison Burket at (202) 783-7100 ext 114 or e-mail at .

** Priority deadline is April 9th, but we urge you to submit your application as soon as possible. **