CONTINUING EDUCATION APPLICATION

Clinicians working within stroke care in the West GTA Stroke Network Regions (Regions of Halton, Peel, Dufferin, & Etobicoke) can be funded for up to $750.00 per fiscal year to attend courses that will improve their stroke knowledge
An application committee reviews all of the funding applications. The committee will assess whether the course content is supported by stroke best practices. Please note that we ask that your manager is made aware of the request for funding.
Please note that the committee strives to ensure fair representation throughout the West GTA Stroke Network when considering multiple applications. The turnaround time for application review is approximately 4-6 weeks.
Applications will be accepted either before or after course attendance, however, applicants must pay for courses in advance and submit original receipts. A copy of the certificate of attendance must be submitted following course attendance.
Please note that the educational opportunity must occur within the same fiscal year in order to be considered for funding.
If funds are not used due to course cancellation or inability to attend a course, funds must be returned to the West GTA Stroke Network
If you have any additional questions about the Continuing Education Fund please don't hesitate to contact us at westgtastroke@thp.ca

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* 1. Contact Information

First and Last Name

Organization

Role/Position

Area of Practice

Manager's Name

Manager's email address

Is your manager aware of your application

Your Email Address

Your Phone Number

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* 2. Cost

Total Amount Requested

Actual Conference/Course Fees

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* 3. Program/Educational Event Description

Program Tittle and Description

Date and Duration of Program

Location of the Program

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* 4. Funding History

	Answer
Have you applied elsewhere for funding pertaining to this application	Have you applied elsewhere for funding pertaining to this application Answer menu
Have you received funding from the West GTA Stoke Network in the past fiscal year?	Have you received funding from the West GTA Stoke Network in the past fiscal year? Answer menu

If you have received funding or partial funding elsewhere please provide name of funding agency and amount received. You may be asked to provide proof of this funding.

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* 5. Briefly explain how this learning or educational opportunity will:

Benefit your stroke practice (ie. professional development, level of stroke knowledge)

Benefit your organization, including colleagues

Benefit stroke clients and their families

Link with the strategic priorities of the West GTA Stroke Network and the Ontario Stroke Network (in terms of health promotion, prevention and/or patient education).

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* 6. How are you planning to share your learning after attending this educational event?

Lunch and learn

Develop informational packet, brochure or handouts for teammates

Hands on demonstration of skills

Other (please describe)

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* 7. Are you willing to share your learning with the West GTA Stroke Network via our website (allowing us to post information or materials) or by being a guest speaker/presenter for us in the future?

Please comment if needed: