Bursary Application

    Your Name (required)

    Your Email (required)


    Your Organization

    Job Title

    Telephone (required)

    Mailing Address (required)

    Employment Status

    Funding requested for

    If indicated other in the above, please specify

    Name of Course or Activity

    Date of Course or Activity

    Location of Course or Activity

    Web Link to Course or Activity if available

    How will participation in this professional development activity benefit you and your organization?

    Detail of Expenses

    Amount Requested

    Have you applied to another organization for financial assistance

    If yes which organization

    Additional Comments