Review Your Application Before Submission
Contact Details:

Name:

Address:

Dianne Musgrove

636 Old Village Road

Birch Island ON

P0P1A0

Phone:

705-285-1913

email:

Course Details and Funding Request

Course:

Level 1 - Part B

Location:

North Bay

Date:

July 17, 2022, 4:00:00 a.m.

Course Tuition: $

350

Amount Requested: $

350

Why are you interested in taking this formation at this time?

Tell us about how you plan to use your formation.

Atrium:

Director:

Previous Scholarships:

If you have previously received funding from the scholarship fund please answer the questions below:

For which level of formation did you receive the funding?

How much did you receive?

How have you used the formation for which you received funding?

Additional Financial Considerations: 

Are there other financial factors you would like us to consider when reviewing your application? (eg. Travel costs, accommodation, child care, etc.)  

What other financial support is available to you? (eg. Parish)

References:

Name of Reference #1:

Contact Information (phone and/or email):

Name of Reference #2:

Contact Information (phone and/or email):

If scholarship is approved to whom should we make out the cheque?

Dianne Musgrove