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Health & Recreation Grant Application
Health & Recreation Grant Application
docmedia
2021-09-09T21:20:17-07:00
2024 Health & Rec Grant Application Form
"
*
" indicates required fields
Application Deadlines:
First Deadline: April 26, 2024
Cheque Issued: May 24, 2024
Second Deadline: October 24, 2024
Cheque Issued: November 29, 2024
Each registered Tsawout Member, 18 years of age and older must complete an application in order to receive the grant.
Name
*
Last Name
First Name
Middle Initial
I am a registered Tsawout member.
*
Yes
No
Status Card Number
*
Date of Birth
*
Month
Day
Year
Telephone Number
*
Address
*
Street Address
PO Box
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Proof of Residency
*
Proof of residency can include a utility bill, driver's license, Care Card.
Max. file size: 80 MB.
Dependents
Are you claiming dependents?
*
Yes
No
Add Dependent(s)
Child's Full Name
Status Card Number
Birth Date
Is this dependent your child?
Actions
Edit
Delete
There are no
Dependents.
Add Dependent
Maximum number of dependents reached.
Intended Use of Grant
Please select one or more intended uses of Grant
Health Uses
*
Conference Registration
Transportation Cost
Cultural
Travel Costs
Other health use
Recreation Uses
*
Sports Registration Fee
Equipment Purchases
Lessons
Fitness Membership
Other recreation use
Applicant Signature
*
Date Signed
*
Month
Day
Year
Δ
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