2020 Educators’ Forum: Application to Attend

Thank you for your interest in the 5th Annual Educators’ Forum: Promoting Effective STBBI, HIV, Hepatitis C and Harm Reduction Education with Indigenous Peoples of BC, taking place March 3 – 4, 2020.

Application for this event is now closed.

Please contact Stacy Leblanc if you have questions about your application: [email protected]

Applicants will be informed of their status by Wednesday, February 5, 2020.

GENERAL APPLICATION INFORMATION

Information collected via this application form is confidential and will be used solely for the purposes of determining attendance, evaluation purposes and for post-event follow up by the event sponsors. All questions marked with a * require a response.
By completing and submitting the information requested in this online application form I am acknowldeging that I have read, understood and accept the travel and accommodation guidelines, the cancellation and no-show policy and the expense reimbursement guidelines on the previous page. I also agree to complete the post event evaluations (one at the end of the training itself and a follow-up survey 3-6 months following the event).(Required)
Name(Required)
Health Authority applicants please note: we will do our best to support as many applicants as possible, but due to limited funds, subsidy application does not guarantee you will receive a partial or complete subsidy.

SUBSIDY APPLICATION INFORMATION

We will do our best to support as many applicants as possible, but due to limited funds, subsidy application does not guarantee you will receive a partial or complete subsidy.
Are you applying for a travel subsidy? (Flight, ferry, mileage reimbursement, etc.)(Required)
Those requesting travel subsidy will be contacted for further information. For those who receive travel subsidies, please note that the BASE PRICE of a flight will be covered, but any additional charges are the responsibility of the individual or their organization. This includes, but isn't limited to, baggage costs, changes to reservations, and other fees.
Are you applying for a hotel scholarship?(Required)

Subsidy Application - Hotel Reservation Information

Please complete the information below to streamline the registration process, should your application be accepted. PAN will book hotel stays for two nights: March 2 and March 3. If you need alternate or additional dates, you must contact Stacy Leblanc or Janet Madsen at PAN to arrange this as soon as you you have completed this application. Shared accommodation is available at no charge to accepted participants. IF YOU REQUEST A SINGLE ROOM, YOU/YOUR ORGANIZATION WILL BE INVOICED A CHARGE OF $95/ NIGHT. You will receive this in your information package or immediately following the Forum. Please Note: A credit card or cash deposit will be required upon check-in for incidentals/damage deposit. If you do not have a credit card or are not able to pay a cash deposit, please let us know below in the "special requirements" section. PAN does not cover room service or incidental charges. I confirm I have read and understood this information.
If you answered yes to the question about hotel scholarship and you require hotel accommodation, please complete the information below. I would like a:
I understand that if I require a hotel room in addition to March 2 and 3, I will contact Stacy Leblanc or Janet Madsen immediately following submitting this application.
Stacy Leblanc: [email protected] | Janet Madsen: [email protected]

MEDIA RELEASE INFORMATION

We will be asking all conference participants to sign a media release form at the onsite registration desk asking for permission to use images and/or videos from the conference for our website, promotional material and reporting purposes. Please indicate below if you will NOT be signing the form so that we can have a name tag that indicates that you do not consent to have your photo taken.
Do you wish to have a special nametag to indicate that you DO NOT want your photo taken or used?(Required)