Regional Council 15 Funding for Ministry Learning Sites Application Form

Please read the background information for this funding which can be found by clicking here prior to applying.

Learning Site*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Name of Candidate in the Ministry Education Program*
First Last
Describe the Ministry Experience (Type of Intership/Learning Site; start/end dates; FT or PT (hours), etc.).*
What ministry needs is the internship supporting? What are the learning goals of the intern as it relates to this application for funding?*
How is the student being supported by the Learning Site? What are the learning goals of the pastoral charge as it relates to this application for funding?*
What are the reasons for making this request for extra funding? How will this funding be used within the internship experience?*
Amount of Grant being requested:*
Cheque payable to:*
Address to send cheque (if different than above)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
What would be the effect on the ministry if the request is NOT granted?*
OFFICE USE:

Request Approval: Yes / No

Amount: $______________

Signature of Chair: ____________________

Signature of Staff Support: ____________________

Date approved by the Region to be a SME: ____________________
Comments
This field is for validation purposes and should be left unchanged.