Advanced Study Grant Application Form

Advanced Study Grant Application Form

Application deadlines: January 15, 2025 or May 15, 2025
Name

First NameLast Name
Address

Street Address

Street Address Line 2

City Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Current Congregational Membership
Current call and/or Staff Position
Application forms submitted for the CEP Advanced Study Grant benefits must include the following (please check off each box to indicate that you have included it with your application):

Current Curricula Vita or ResumeLetters of Reference from Employer including permission to engage in proposed study programLetter of Reference from Synod Bishop or Designate (Rostered employees) or ELCIC Rostered Minister (Lay Employees)Letter of Reference - OtherBudget for the Study Program Form
Current Curricula Vita or Resume*

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Letter of Reference from Employer including permission to engage in proposed study program. Please have your reference email the letter to Deacon Gretchen Peterson, gpeterson@elcic.ca*

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Please arrange for three letters of reference to be emailed to Deacon Gretchen Peterson at gpeterson@elcic.ca
Letter of Reference from Synod Bishop or Designate (Rostered employees) or ELCIC Rostered Minister (Lay Employees)*

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Letter of Reference - Other*

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Budget for the Study Program Form

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Applicant
Proposal Title
This study program is related to the following degree or diploma programs:
Educational Instituation
Degree/Diploma
Website of Institution
Description of Study Program
Does this program involve a study leave?

YesNo
If yes, please indicate how long of a leave.
Proposed start date of study leave

MonthDayYear
Date
What individual goals will be addressed by this study program?
How will you measure success in attaining these goals?
What employer/congregational/agency goals will be addressed by this study program and how will you apply your learning in your current context?
How does this proposed program support our church's mandate to Live Out God's Grace and Unconditional Love?
The major impact of this study program for the chruch and the world will be:
Short-term:
Long-Term:
Study Program Budget
Funds requested
Maximum $9000

A. Course/Workshop/Seminar

	Budget
Tuition
Books
Total Course/Workshop/Seminar

B. Travel

	Budget
No. of Personal KM ($0.40/km)
Airfare
Bus
Train
Total Travel

C. Meals

	Budget
Breakfast
Lunch
Dinner
Total Meals

Other Expenses (if applicable)
Type of Other Expenses
Total Budget (A+B+C+D)
Have you obtained any other funding to help support you in your studies? If yes, please indicate who the funding is from and approximately how much you will receive.
Candidate Signature

Clear
Should be Empty:

Advanced Study Grant Application Form

Study Program Budget