Association for Healthcare Philanthropy Canada (AHP): Bursary Application

BURSARY APPLICATION
Deadline: February, 22, 2008

SECTION 1

Bursury Applied For:

Applicant Name

Title

Organization

Address

City

Prov/State

Postal/Zip

Country

Telephone

(work)

(home)

(fax)

SECTION II

Years of fund
raising experience

Healthcare

Other

# of professionals in department

Fundraising goal
for 2006-2007

Job Function

Experience in
Healthcare/ Fundraising

Level of AHP Certification

Check previously attended

		AHP Regional
		Yrs. attended:

		Madison Institute
		Yrs. attended:

		AHP International
		Yrs. attended:

Please specify compelling reasons why applicant should attend including benefits to the applicant and the organization(s), and challenges in attending professional development opportunities.

Copy and paste a letter of support from the volunteer chairman or institution CEO in the box the right: