Halifax City Local Conference Grant Application
Full name: *
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Six digit professional number: *
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Contract status (Permanent, Probationary, term): *
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School/Work site: *
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Home mailing address: *
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Home or cell number: *
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Non-employer email address: *
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Name of conference: *
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Conference Location: *
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Start date of conference: *
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End date of conference: *
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Brief description of conference: *
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Conference Website: *
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Conference registration fee: *
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Have you applied for Article 60 funding? *
Have you applied for, or been approved for, other sources of funding? *
If yes above, what type(s) of funding:
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Have you read, and do you understand the guidelines for Halifax City Local PD funding? *
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