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MOA Network - Professional Development Funding Application

To receive funds, MOAs need to be a part of the Victoria MOA Network and work in a physician-owned/operated clinic. If you are not already a member please apply here.

As a reminder, funds can be used for:
  • Covering the cost of paid-for MOA training/education (e.g., courses, seminars, webinars), OR covering the cost time spent reviewing or completing free offerings/resources (per individual activity)
  • Group facilitation fees (i.e., funds can be pooled across multiple MOAs at a clinic)
** Compensation can be requested for multiple activities, up to $500/MOA.

Funds can not be used for:
  • Compensating both training fees and MOA time (for the same activity)
  • Meeting expenses (e.g., meeting space or food)
  • Travel
  • Purchase of prizes, gifts or alcohol
Please note that funds can be requested retroactively for activities completed between April 1, 2023 and now (please specify in your application)
Clinic information
1.Clinic name:(Required.)
2.Family Physician name:(Required.)
3.Name(s) of MOA(s) accessing funds:(Required.)
Activity details
Please note that funds may be used to cover MOA time OR course/training fees for a single activity – you must select one reimbursement type for each activity.
ACTIVITY 1
4.Please describe the activity:
5.Link to administering organizing/website, if available:
6.Type of reimbursement required (check one)
7.What is the total cost or time required to complete? (Please specify dollars or hours)
8.Who will reimbursements be made to?
9.Please include any additional activity details you'd like to share.
If you plan to complete a second activity, please describe it below:
ACTIVITY 2
10.Please describe the activity:
11.Link to administering organizing/website, if available:
12.Type of reimbursement required (check one)
13.Fees/time spent - please list course fee/total anticipated MOA time (per MOA)
14.Who will reimbursements be made to?
15.Please include any additional activity details you'd like to share.
Who is submitting this application
16.Full name
17.Contact email
18.Clinic role (check one)
19.If application is being submitted by an MOA/Office Manager, please confirm that the clinic physician has approved of the submission.
Thank you for completing the application. A Division staff will be in touch to approve your submission soon.