Bursaries for Key Staff / VolunteersNational Mentoring Symposium 2016

Provided through a generous grant fromFamily and Community Support Services Association of Alberta (FCSSAA)

The Alberta Mentoring Partnership has a limited number of bursaries to allow staff / key volunteers to attend this event.

The applicant organization must be located in ALBERTA. Priorities will be given to mentoring programs located in rural & remote communities throughout Alberta as well

as programs supporting Indigenous or Newcomer children and youth.We are accepting and reviewing applications until the Bursary fund has been expended.

Applications are accepted on a first-come first-served basis and will be allocated on a monthly basis.

Submit applications to: National Mentoring Symposium 2016 Bursary Selection CommitteeEmail address: bursary@albertamentors.ca By June 1 st , 2016

REQUESTED INFORMATIONLegal Name of Organization / School Authority:

Is your mentoring program located in rural or remote Alberta? Where?

Does your mentoring program support Indigenous children and youth? How?

Does your mentoring program support Newcomer children and youth? How?

Charitable Registration Number: (if applicable)

Address:

Phone:

Fax:

Email :

Website:

Executive Director/Principal/Superintendent

Primary Contact for Application:

What is the name and title of the individual for whom you are seeking the bursary?Why does this individual want to attend the National Mentoring Symposium?

What benefits does this individual expect to see as a result of attending the Symposium?

How will the information this individual gains from the Symposium be passed on to other people involved in your organization?

REGISTRATIONRegistration fee is $500 and includes all meals (this is the early bird rate). After June 6, 2016 the rate will be $700.What is the registration and meals amount you are seeking?

What is the organization/school authority’scontribution?

What is the registrant’s contribution? (if any)

ACCOMMODATIONS(Maximum amount $158.00 each night for 3 nights at the Rimrock Hotel, the conference site.What is the accommodation amount you are requesting to be paid by the bursary?What is the organization/school authority’s contribution?

What is the registrant’s contribution? (if any)

TRAVELHow many Kilometers will you be travelling?

How are you travelling? personal vehicle bus planeWhat is the personal vehicle travel amount you are requesting to be paid by the bursary?What is the plane travel amount you are seeking to be paid by the bursary?

What is the bus travel amount you are seeking to be paid by the bursary?

What is the organization/school authority’s contribution?

What is the registrant’s contribution? (if any)

WHAT IS THE TOTAL AMOUNT OF THE BURSARY THAT YOU ARE SEEKING?

Please provide us with the names and telephone numbers of the senior staff members of your organization OR the chair of your board.SENIOR STAFF PERSON OR BOARD CHAIR / PRIMARY SUPERVISOR

Name:

Telephone:

Title:

All Bursary cheques will be available for pickup at the registration desk at the symposium / or mailed to you after the symposium.Cheque to be made out to:

If the funds are needed in advance please let us know by answering the following question.I will require the funds in advance. No YesPhone number to call you at: Best time of day to call you at: