Pro-D Bursary Reporting & Claim Form

Name*

First Last

Where are you located?*

City

Email*

Phone

Title of Pro-D Activity*

Location of Pro-D Activity*

Date of Pro-D Activity*

Summary of Expenses Claimed:*

Description	Cost

Please note that you can only claim for up to the amount awarded. Mileage can be claimed according to our Mileage Rates, Breakfast can be claimed at $11, Lunch can be claimed at $12.50 and Supper can be claimed at $22.00)

Please upload your receipts here.

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 32 MB.

If you aren't already set up with us for electronic payments, please upload a voided cheque or banking information form for direct deposit.

Accepted file types: jpg, png, pdf, Max. file size: 32 MB.

We pay using electronic payments to your bank account.

In 200 words or less, please describe what you learned that we can share with other CBEEN members. Please specify any knowledge or skills that might help them in improving their environmental education programs.

What resources would you recommend to CBEEN members that you discovered as a result of the Pro-D opportunity? Please list up to 3. This can be a website url directing to a resource, or the name of a ‘physical’ resource/tool (url preferred).

As a result of this professional development opportunity, what actions will you take to improve your environmental education programs/methods?

Please upload a photo of you at your Pro-D activity that we can use to promote the Pro-D Bursary Program and help to share what you learned. (*This can be used in the feature image of the blog post)

Drop files here or

Accepted file types: jpg, Max. file size: 2 MB, Max. files: 3.

Any other comments or information you’d like to provide:

Please follow the post-submission instructions to email photos of your Pro-D Activity, and scans of your receipts. Thank you for your attention.