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Continuing Education Grant Application

> What We Support > Continuing Education Grant Application

Live Forms

Applicants Information
First Name
Last Name
Address
City or Town
Postal Code
Email
Phone
Phone Number
Preferred Method of Contact

Email Text Phone
Have you ever received DGHF funding?

Yes
No
What is your highest level of education completed?

Diploma
Baccalaureate Degree
Masters Degree
Masters NP
PhD
What is your primary area of practice?

Hospital Public / Population Health
Continuing Care
Educational Institution
Business/Industry/Occupational Health
Government
Others
What is your primary role?
(Registered Nurse, Nurse Practitioner, X-ray tech, lab tech, etc.)
Where is your primary place of employment?
(e.g. Royal Alex Hospital, Devon General Hospital, etc.)
Eligibility - CRNA Registration Number for 2025 Practice Year
(if applicable)
Nursing Credential (if applicable)

NP
RN
Educational Activity
Did you complete this educational activity within the current or previous calendar year?

Yes
No
Educational Activity - Choose one

Conference
Workshop
Initial certification
Recertification
Specialty course/program
Post basic degree
Graduate level course/program
If taking degree level studies, what level of degree are you studying?

Baccalaureate
Masters
Masters NP
PhD
Others
You may only apply for completed courses
Educational Provider or Host Organization
Name of Course or for Degree courses Semester
Date course/workshop/conference or semester completed?
Year - Month - Day
What impact did this educational activity have on your work in the healthcare sector?
The answer to this question assists in making funding eligibility decisions.
Proof of Completion
Please upload proof of completion of educational activity/course such as - certificate of attendance, provider cards or non-official transcripts. Documentation provided - Must show applicants full name and final grade. This should not be your course registration document but proof of completion of the course.
Proof of Completion Upload
Filename
Size
Process
Status
Add Files
Max file size:4MB, Format: pdf,doc,docx,jpg,jpeg,png,gif
Proof of Payment
Proof of payment must be equal to or greater than $2500.00. Proof of payment should be an official document that shows applicants name.

Upload receipt, paid invoice, bank statement or credit card statement that show your name and confirms payment. For university courses, provide a University proof of payment . No Screenshots.
Proof of Payment Upload
Filename
Size
Process
Status
Add Files
Max file size:4MB, Format: pdf,doc,docx,jpg,jpeg,png,gif
Additional information: Include any details on the payment if paid in installments or any information you think is required to help us process your application.
Electronic Funds Transfer

T4As will be issued to all individuals who receive Educational Grant of over $500.00 in the calendar year. Funding will not be provided without a SIN number.
I give my express consent to DGHF to contact me electronically

Yes
No

T4A Agree

T4As will be issued to all individuals who receive Educational Grant of over $500.00 in the calendar year. If I am successful in receiving the grant, I will provide my social insurance number to the Devon General Hospital Foundation.

GivePermission

I hereby grant permission to the Devon General Hospital Foundation Education Grant Committee to contact my school/educational institute to request further information if required.
If Successful

If I am successful in receiving the grant, I give permission for the Foundation to make my award public.
I Agree

I hereby acknowledge that I have reviewed the terms and conditions for the Education Grant program and confirm that I meet the eligibility requirements to apply.
Deadline For Submissions is October 31th, Midnight.
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