Bursary Fund – Agency Application Bursary Fund - Agency Application Bursary Fund - Agency Application This application will take about 45 minutes to complete. Download this form if you wish to preview the questions and collect necessary information. Fill in and submit the application using this website.Please do not send a PDF. There is no way to save this form and finish it later. Need Help? Contact Us Before you begin you will need know: Your agency’s Charity Registration Number (A charity registration number is 15-digit program account number assigned to a charity by the Canada Revenue Agency). The format of training you will offer (community of practice, conference, course, retreat, institute, workshop) A list of anticipated costs for this professional development A. Contact Information (* Indicates Required Field)Agency NameAgency Mailing AddressAddressCityPostal CodeFirst NameLast NameYour Contact Phone NumberYour Agency PositionPreviousNextB. Requirements for FundingNon-Profit Charity Status To be eligible for bursary funds: Your agency must be a non-profit organization that provides professional development for child care professionals. Your agency must be a qualified donee with a Charity Registration Number. 1. Charity Registration NumberIf you are another non-profit agency that provides professional development for child care professionals but you do not have a Charity Registration Number, check this box. My agency/group does not have a charity registration number.Demographic Information of Participants Locations After the professional development event is finished, the postal codes of those who participated must be collected and provided to the bursary team in a spreadsheet format. 2. Will you collect postal codes of participants and provide a spreadsheet list to the bursary fund team? Yes Not sure howPlease state your questionIndigenous Self-Declaration This Bursary Fund aims to support child care professionals who self-identify as First Nations, Métis or Inuit. We need to collect this information for reporting purposes. 3. Will you request Indigenous status of your participants and provide a list to us that includes how many people self-declared and their self-declared designation of their community? Yes Need clarificationPlease state your questionProfessional Designation The professional level of participants must be collected. 4. You will need to identify participants in the following categories of practice. • ECE• ECE Assistants• School Age Child Care Providers• Licensed Family Child Care Providers• Registered LNRs• Responsible Adults (20 hours of training)• Others: Those who work in the child care and learning sectorWill you collect the professional level of participants and provide this information? Yes Have questionsPlease state your questionPreviousNextC. Evaluation (Click here to view report form)1. Will you participate in an evaluation process that will include a brief online report and/or meetings with the Bursary Team? Yes Have questionsPlease state your questionPreviousNextD. Professional Development Plan1. What will be the format of your professional development? Community of Practice Conference Retreat One-Day Event Workshop (outside regular programming) OtherPlease specify1a. If you are planning a community of practice. Please review the community of practice implementation plan that you will be asked to follow.If you have questions, state them below2. What is the topic or subject area of this professional development?3. What will be the format of this professional development Face-to-face Online A blend of both face-to-face and online I'm not sure4. When do you plan to offer this professional development? Provide dates below:5. Briefly describe the plan and purpose of this professional development. Need help with the description? State your questions below. 6. What are the success outcomes you are aiming for with this professional development?A key objective of this Bursary Fund is to build capacity among child care professionals. This is interpreted as “building the potential for a person to experience, demonstrate or perform a competency/expression or understanding.” 7. How will this professional development experience build capacity with your participants?8. How will you measure capacity-building with this professional development? Survey Interview Other Not sureState your questions below9. How do you predict these bursary funds help to build professional capacity with your participants?10. Specific feedback from participants is very important to this Bursary Fund Project. Will you share pertinent comments/feedback/quotes from participants? Yes Not sure11. Will you be collaborating with other agencies or communities? Yes, please describe below No No, but if we would like to collaborate with other agencies/communities. Please describe your intentions or questions below.12. How will you extend your reach to other communities such as First Nations, Métis and/or Inuit communities to invite them to participate in this professional development? Not sure? Share your questions below.13. How will you reach out to child care professionals in rural and remote areas to participate in this professional development? Not sure? Share your questions below. 14. How many people do you anticipate will attend this professional development experience?15. Will your agency provide a certificate for professional development hours obtained by participants? Yes NoPreviousNextE. Anticipated Costs1. Describe your agency’s plans for using Bursary Funds. Consider costs such as reducing registration, subsidizing travel expenses, accommodation, learning resources, speaker fees, facility rental, and/or catering. If Bursary funds are requested to reduce registration fees, please describe the full cost of the registration fee in the Description field and the amount supplemented by the Bursary funds in the Cost field. DescriptionCost ($)DescriptionCost ($)DescriptionCost ($)DescriptionCost ($)DescriptionCost ($)DescriptionCost ($)DescriptionCost ($)TOTAL COSTSTotal Cost ($)2. Describe other funding or any other revenue you expect to obtain in order to also further reduce the costs to participants.RevenueAmount ($)RevenueAmount ($)RevenueAmount ($)RevenueAmount ($)TOTAL REVENUETotal Revenue ($)TOTAL FUND REQUEST ($)Is there any more information you would like to provide or questions you may have?Please enter your work email addressPlease confirm your email addressHow would you rate your experience in filling in this form? Previous Submit Form
