CONTINUING EDUCATION BURSARY APPLICATION
Applicants must meet all of the following requirements to be eligible for consideration for this bursary:
Certificate in Public Health Inspection Canada CPHI(C)
2024 Regular Member of CIPHI
Working in the field of environmental public health
Enrolledi in a Masters or PhD program
Statement outlining how your continuing education would benefit your career
Proof of enrollment and succesful completion will be required
Name
*
First Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Employer
*
Please provide your CPHI(C) No.
*
Educational Institute and Faculty Currently Enrolled
*
Course or program
*
Program start date
*
/
Month
/
Day
Year
Date
Expected completion
*
/
Month
/
Day
Year
Date
Attending
*
Part-time
Full-time
Please provide a statement on "how your continuing education will benefit your career".
*
Maximum 500 words
0/500
Signature
*
Please verify that you are human
*
Submit
Submit
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