RMGNA Small Grants Application Form

Your details
Name*

First NameLast Name
Your application will be de-identified during the review process; please provide a pseudonym for us to use or leave this blank and we will create one for you.*
Single word only e.g., unicorn, JayBee, etc.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number*
Mobile phone number or landline (area code)(phone number)
Email*
example@example.com

About your work
What is your current position/role?*
Please provide your role name & a brief role description
Please describe your workplace *
e.g., hospital, GP, home care, research office, etc.
Clinical area/specialty*

Activity details

Conference, journal subscription, online learning, etc.
Name/type of activity*
For example, National Nurse Education conference, Sydney, 2025 or The Journal for Nurse Practitioners
Provider/organisation*
Topics or general theme/s*
For example, the conference theme is 'Riding the waves of change' i.e., the dynamic nature of nursing education in a constantly changing healthcare environment
Date(s) or total hours *
If not applicable to your submission, for example a journal subscription, please enter n/a for this field
URL/web link (if available/applicable)
Please upload supporting evidence for your application e.g. course enrolment form, a subscription receipt, purchase receipt, etc.

Cancelof

Bank account details

If your submission is successful, it will make it easier and quicker to transfer the grant monies if we already have your banking details; alternatively, you can provide these details when you are notified that your grant application was successful.
Account name
BSB number
Please enter the BSB number without spaces or hyphen e.g., 032644
Account number

Declaration
As a condition of accepting an RMGNA small grant, I agree to provide a summary of the funded activity, my key learnings and the implications for practice which will be shared with the members of the Association as:*

an article for publication in the Association’s newsletter (within 6 months of completing the activity); and/ora presentation at an RMGNA meeting
Do you agree to the above declaration?*

YesNo
Signature

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Please click the continue button below to confirm your signature and you are done!

You should receive an autogenerated email that confirms your application has been sent to the RMGNA committee for consideration at the next committee meeting.

If you do not receive this autogenerated email or have any further questions or concerns after applying, please contact us at rmhgna@outlook.com

Small Grants Application Form