Financial Assistance Conference/Travel Bursary Application Form

Transcription

1 Financial Assistance Cnference/Travel Bursary Applicatin Frm At the discretin f the Bard: 1. Membership f a Lcal Assciatin must be current and cntinuus fr at least tw years. 2. The Lcal Assciatin President must supprt the applicatin, with written ratificatin supplied by the Lcal Assciatin Secretary including verificatin f cmmitment t lcal assciatin activities. 3. Financial assistance will be awarded t an individual member n mre than every three years. 4. The maximum amunt f financial assistance awarded is The applicatin fr bursary funding must be directly related t a periperative cnference r ther educatinal activities. 6. Applicatins will be cnsidered fr frmal qualificatins if they are directly related t the periperative envirnment. If applicatin is successful, 50% f grant will be available upn cmmencing study and the remaining 50% n cmpletin f the educatinal activity. 7. Financial assistance must be allcated tward csts assciated with cnference registratin and/r travel and/r accmmdatin and/r frmal qualificatins. 8. Financial assistance applicatins clse 2 mnths prir t a natinal Cnference / educatinal activity and 3 mnths fr an internatinal activity. Applicatins may be ldged any time prir t this. Applicatins will be assessed quarterly - February, May, August and Nvember. Applicants will be ntified as sn as pssible after each assessment perid f the utcme. 9. Assistance will be prvided as reimbursement fr csts r as direct payment t an rganisatin fr registratin etc. N cash sum shall be given t the applicant withut evidence f payment. 10. Retrspective applicatins will nt be cnsidered. 11. Cnfirmatin f financial assistance can be made in principle by the Bard t allw members t engage with the csts f the educatinal activity with cnfidence. 12. All applicatins will be cnsidered n merit. 13. The decisin f the bard is final and n crrespndence will be entered int.

2 14. All members wh receive financial assistance must submit a reprt abut the funded activity n later than eight weeks after attending the activity. The reprt may be up t 1500 wrds and phts may be included. At the discretin f the Jurnal Editrial Cmmittee, the reprt may be published in the ACORN Jurnal and/r the ACORN website. 15. Successful applicants must: agree t have their names and State published in the ACORN Jurnal agree t allw ACORN t cmmunicate with the apprpriate Lcal Assciatin t cnfirm r crrbrate the applicant s level f activity within the rganisatin. agree that the final reprt may be published in the ACORN Jurnal and/r n the ACORN website. agree t acknwledge the financial supprt awarded by ACORN at the apprpriate time e.g. at the beginning f a presentatin. Cmpletin f Financial Assistance Applicatins: The ACORN Bard wishes yu every success in regards t yur applicatin but wuld like t remind applicants t explre all ther pssible surces f financial assistance. Applicants are respnsible fr ensuring all items relating t their applicatin are received by the ACORN Secretariat. T apply fr financial assistance all f the fllwing must be submitted: 1. A cmpleted Financial Assistance Applicatin frm. Incmplete applicatins will be returned t yu fr cmpletin. 2. Registratin brchure r Call fr Abstracts brchure, utline f educatinal activity. 3. If yu are presenting at the cnference, please prvide a cpy f yur abstract and, when available, cnfirmatin f yur abstract acceptance letter. 4. Details f the charitable activity and cntact details f the rganisatins invlved with the venture. 5. Include travel and accmmdatin qutes, r supply bking receipts, t substantiate yur requests if applying fr these cmpnents f the cnference/seminar. 6. Cmpleted frms and supprting dcumentatin must be sent t ACORN by ne f the fllwing methds: administratr@acrn.rg.au Pst PO Bx 899 Lyndch SA 5351 Fax is the preferred methd.

3 Part 1: Persnal details Name: Address: Cntact details: (h) (w) (mb) (fax) ( ) Currently emplyed by with the title f full time equivalent Part 2: eligibility check LA Membership: Which lcal Assciatin d yu belng t? Hw lng have yu been a member? Please indicate the activities yu have been r are currently invlved with at a state r natinal level. These activities can include cmmittee membership, attendance at meetings, cnferences, study days, fund raising etc

4 Previus financial assistance frm ACORN: Have yu ever received financial assistance frm ACORN? N If yes, please describe the activity yu received financial assistance fr: Date and amunt received: Part 3: The activity Place and date: In what capacity are yu attending the activity? Please circle: delegate vlunteer invited speaker submitted paper ther Paper accepted (prvide prf f acceptance and cpy f abstract). Title and brief utline f activity, yur bjectives and hw it will benefit yur practice:

5 Expenses self funded financial assistance Other ACORN Registratin r Enrlment feee Travel Accmmdatin Other (please specify) Ttals Ttal financial assistance requested frm ACORN Wuld yu accept partial funding? (By answering n t this questin yur applicatin may be rejected if the ACORN Bard decide t award partial funding). N Have yu applied elsewhere fr financial assistance fr this activity? If s prvide details. Please include any further infrmatin that yu feel will supprt r clarify yur applicatin. If successful I agree t ACORN cnditins f acceptance (as per pint 14-15) Signed Date

6 Ntificatin f utcme Please ensure that the details supplied in Part 1 Persnal details are crrect and indicate ne r tw methds f ntificatinn t let yu knw the utcme frm yur applicatin. Fax Hard cpy letter Unsuccessful applicatins: Yu shall receive ntificatin frm ACORN indicating that yur applicatin has been unsuccessful. The Bard shall infrm yu why yur applicatin has been unsuccessful. N discussin shall be entered int. Successful applicatins: Yu shall receive ntificatin frm ACORN indicating that yur applicatin has been successful. ACORN s preferred methd f settlement is Direct Credit int yur bank accunt. The ACORN secretariat will cntact yu fr yur bank details if nne are prvided. If yu have supplied qutes and require ACORN t pay fr items, such as registratin, ACORN shall cntact yu t ensuree that yur funding needs are met. ACORN shall nt bk accmmdatin r flights.

7 Part 4: Checklist fr inclusin f all the necessary dcumentatin Evidence f current and cntinuus Lcal Assciatin membership. Ratificatin f applicatin by Lcal Assciatin Secretary. A cmpleted Financial Assistance Applicatin frm. If yu are presenting at a cnference, a cpy f yur abstract and, if available, cnfirmatin f yur abstract acceptance. n/a N Details f the charitable activity and cntact details f the rganisatinss invlved with the venture. n/a N Registratin n/a qute receipt Travel n/a qute receipt Accmmdatin n/a qute receipt Other *NB: This page must be sent with applicatin when submitting applicatin