Partnership Brokers Training Application Form - Ottawa October 2020
Please read carefully, complete in full and submit to be considered for participation in this course to be held October 5-8, 2020 in Ottawa, Canada.

This form will take approximately 30 minutes to complete. Make sure you give yourself enough time to complete the entire form in one sitting as you will not be able to save a partially filled form to complete at a later time.

To preview the form questions as a PDF, visit this page:
Personal Information
Title (Mr/Mrs/Ms/Dr...)
Your answer
First Name *
Your answer
Last Name *
Your answer
Nationality *
Your answer
Will you require a visa invitation letter? *
Profession and Qualifications
Job Title *
Your answer
Organisation *
Your answer
Sector *
Focus Area *
Key skills
Your answer
Contact Information
Email *
Your answer
Phone (include country code) *
Your answer
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
Province/State *
Your answer
Postal/Zip Code *
Your answer
Country *
Your answer
Additional Information
Please indicate whether you can demonstrate any (or all) of the following:
How did you find out about the course? *
Please provide name of trainer or previous participant.
Your answer
Please advise if you will require any form of special assistance or adjustments, including physical, mental health, learning or other considerations to enable you to access the course. Please feel free to contact our Training Manager ( to discuss.
Your answer
Do you have any dietary restrictions? Select all that apply. (breakfast, lunch and snacks are provided)
Emergency contact name *
Your answer
Emergency contact phone number *
Your answer
Expectations of Partnership Brokers Training
Tell us about yourself and why you are interested in Partnership Brokers Training. Your responses here will help inform the training team of your unique needs.
What are your objectives in taking this course? *
Your answer
What elements of your partnership/brokering practice are you most keen to address? *
Your answer
What are the key brokering challenges you are currently facing? *
Your answer
How will you integrate the partnership brokering training into your day-to-day work? *
Your answer
Invoicing and Organisational Agreement
Course Fee
Partnership Brokers Training fee payable CAD 2,500.00 excluding HST (total $2,825 including HST).

The Partnership Brokers Training fee covers:
• all tuition fees
• background reading materials and course handouts
• refreshments during the course

The Partnership Brokers Training fee does NOT include:
• travel costs involved in attending the course
• accommodation and meal costs
• per diems for participants during the course
• chargeable telephone calls
• bank or credit card charges

Once an applicant has been formally accepted and offered a place on the Partnership Brokers Training, the nominated organisation or person (as stated in the invoicing section of the application form) will be issued with an invoice for fees.

The place in the course is only confirmed, if payment of the full course fee is received by the date stated on the invoice. The applicant is responsible for timely payment of this invoice, regardless of the donor. If payment is not received within the stated payment terms, PBA reserves the right to forfeit the place and offer it to another applicant. Pre-course reading and logistics information will be sent two weeks before course commencement, providing invoices have been paid and attendance is confirmed. For those arranging flights, it may be helpful to know the program commences at 8:30am on Day 1 and finishes at 5:30pm on Day 4. Full attendance is a requirement for certification.

A maximum of six bookings from the same organization are allowed, in order to foster diversity in the program.

Any questions should be directed to
Course Payment
An invoice for the full course fees will be issued once your application has been approved.
Payment type
Invoice details: who should we invoice for the course fees *
Invoice Details
Organisation name
Your answer
Contact name
Your answer
Contact email
Your answer
Address line 1
Your answer
Address line 2
Your answer
Your answer
Postal/ZIP code
Your answer
Your answer
Grant application
Those involved in climate action, working in the Greater Toronto and Hamilton Area can apply to The Atmospheric Fund's Social Innovation Skills Fund to receive tuition support.

For more details on eligibility criteria and process, and to apply, visit
Do you intend to apply to The Atmospheric Fund's Social Innovation Skills Fund? *
Cancellation Policy
Cancellation by Candidate
Once accepted into the course and an invoice for payment of fees has been issued, a cancellation fee will be immediately due should the candidate withdraw, irrespective of whether or not payment has been made. The cancellation fee is as follows:

- 50% of the program fee for withdrawals made within three weeks of the course start date.
- 100% of the program fee for withdrawals made within one week of the course start date.
Cancellation by Organizers
If, for whatever reason, the course is postponed or cancelled by the organizers, applicants will be notified at least one week before the start date of any such changes. The Atmospheric Fund / PBA cannot accept liability for any expenses incurred. There will be a full refund of any course fees paid.
Consent and Privacy
I confirm that I have read and understood the information provided in this form, and that the information which I have given in this application is complete and true. *
At PBA, we take your privacy seriously. We will only use your personal information to contact you with details about the training course/s you registered for and other activities we provide. We will only communicate with you when we think it will be useful and of interest. You can find out more about our Privacy Policy at PBA will ensure all data is recorded and stored safely and is only used with regards to our activities. If you consent to us contacting you for these purposes, please tick below to confirm.
I consent to PBA adding my name, organisation or company details and email address to a list to be shared with other members of my training cohort. This list will only be shared with training cohort members and trainers. If you consent to us sharing your details for this purpose, please tick below to confirm:
I consent to being photographed during the course and have these photos used for promotional purposes.
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