LEAF - EEF

Please note: Online application requires you to have ALL your documents in electronic format AND attach them to this form.

A NEW ADDITIONAL LEAF 2020 FUNDING OPPORTUNITY

ANNOUNCEMENT FOR OFCP MEMBERS

LEAF EDUCATION ENRICHMENT FUND

OPENING OCTOBER 22, 2020

IMPORTANT INFORMATION FOR OFCP MEMBERS

Due to the evolving situation surrounding the Coronavirus (COVID-19), your wellbeing and safety is our number one priority and we continue to support you to meet your needs during this time. Please know that we monitor current events as they unfold and will stay connected with you.

OFCP is pleased to announce a new LEAF Education Enrichment Fund – an additional funding opportunity to our Members to help them cover additional educational expenses they may have. The following are the guidelines and application processes regarding this new LEAF Education Enrichment Fund.

1. OFCP offices remain temporarily closed and we are accepting online applications only and not applications that are sent by postal mail or fax.

2. All students who are OFCP Members and are attending an Ontario Board of Education Elementary or Secondary School, or an Ontario College/University are eligible to apply for funding. Maximum eligible one time amount per applicant is $500.00.

3. We will accept quotes for items and activities requested for funding assistance and will also accept receipts for items and activities purchased as of July 1, 2020 to December 31, 2020 until all funds dedicated to OFCP LEAF Education Enrichment Fund are utilized.

4. Eligible items and activities may now include, but are not limited to:

Tutors
Text books
Educational apps and subscriptions
Laptops, desktops
iPads
Headphones
School supplies
Tuition fees
And any other tools to support learning

Not limited to the above list, OFCP will try and accommodate each request as it pertains to the learning expenses during the time of COVID-19 emergency situation.

Complete this application form in full. Attach all required documentation. Incomplete applications will be returned.

Fields marked with a red * are required fields

* If you require additional information regarding this application or have any questions please contact us.

How would you like OFCP to make the payment: *

Pay me through direct bank deposit (bank deposit info required) Pay the vendor directly

IMPORTANT INFORMATION REGARDING DIRECT PAYMENT FOR APPROVED ITEMS AND ACTIVITIES

Once your application is approved, OFCP will be able to send you a payment via direct deposit. In order for OFCP to complete this transfer, follow the steps listed below:

Read the direct deposit information required for all LEAF and ADFP payments, please click here.
To receive a direct deposit payment from OFCP LEAF and ADFP programs, please attach and/or upload a copy of your bank cheque or bank direct deposit form below.

Attach copy of cheque or deposit form here *

Browse Files

I hereby authorize OFCP to deposit my LEAF/ADFP payment in the bank or financial institution designated with the attached cheque or direct deposit form. *

I Authorize OFCP

I acknowledge that the banking information provided for the direct deposit agrees with the information provided on my application. *

I Acknowledge

If you selected the OFCP to pay the vendor, (above) OFCP will arrange the direct payment details with the vendor directly.

Date

yyyy mm dd

Individual Membership ID # *

(Applicant)

Applicant's Information

Name (who the item/activity is for)

First Name Last Name

Date of Birth

yyyy mm dd

Diagnosis

Address

Street Address

Street Address Line 2

City Province

Postal Code

Home Number

Area Code Phone Number

Bus. Number

Area Code Phone Number

Email

example@example.com

If the above address is new, please update my info

Update My Info

I Would like to receive OFCP communications

By email By postal mail

Primary Contact

Name of Primary Contact (parent or guardian required if the applicant is under 18 years)

First Name Last Name

Relationship to applicant

Address

Street Address

Street Address Line 2

City Province

Postal Code

Home Phone

Area Code Phone Number

Bus. Phone

Area Code Phone Number

Email

example@example.com

If the above address is new please update info

Update Info

I Would like to receive OFCP communications

By email By postal mail

Activity / Item Information

I am a student at

Name of school

My school location

School address

Current grade or school year (if applicable)

Current grade, school year or kindergarten (K) (if applicable)

I am applying for

Name item or activity here

Duration of Activity - Start date of activity (if applicable)

yyyy mm dd

End date of Activity (if applicable)

yyyy mm dd

Item vendor/Activity Provider

In what way(s) would this item or activity enrich your life?

Do we have permission to use your story in our promotional material (facebook, newsletter, etc...)

Yes No

Funding Summary

LEAF Education Enrichment Fund (LEAF EEF)

Funding Request Summary

Note: OFCP will consider one-time LEAF EEF request up to a maximum of $500 per member per funding year until all funds are utilized.

Estimated total cost for item/activity (item/activity provider quote or receipt required)

Amount ($)

Total funds requested from OFCP

Amount ($)

Checklist

Please complete before submitting your application *

Have you read ALL the guidelines and eligibility criteria including who can apply Have you included a price quote/estimate or receipt (required from the item/activity provider) Have you included information about the item/activity (required from the item/activity provider) Have you attached a copy of your bank cheque or bank direct deposit form

Have you included one of these documents *

An invoice or quote from the item/activity provider? Paid receipt for the item/activity (not required for initial application, but required upon approval after activity completed)

Financial Need

(Check off your household yearly income)

Under $20,000 Between $25,000 and $45,000 Between $45,000 and $70,000 Between $70,000 and $95,000 Over $95,000

Please explain your financial circumstances to help up understand why you are applying for LEAF

Indemnity

I hereby indemnify and save harmless the Ontario Federation for Cerebral Palsy, its officers, directors, employees and agents from and against any and all claims, demands, liabilities, losses, costs, expenses, damages, actions, suits and other proceedings arising out of the activity described in this application. I understand that the Ontario Federation for Cerebral Palsy acts as a third party funder and as such has no role in choosing, recommending or selecting an activity, product or equipment and that any payment from OFCP LEAF program is not an cknowledgement that the activity is acceptable for the purposes intended.

Privacy

The OFCP collects, uses and discloses personal information related to this application only for the purposes of assessing, processing and administering this application and may exchange such information with the above-mentioned contact person, vendors, medical professionals and other agencies. I consent and (as applicable) confirm the user’s consent to this collection, use, disclosure and exchange of personal information. For additional information regarding the OFCP’s personal information protection privacy practices, please refer to our Privacy Policy on the OFCP website.

Certification

I certify that the information provided in this application is true, correct and complete to the best of my knowledge *

Yes

I confirm that I have read and understand all of the OFCP LEAF EEF Program criteria *

Yes

Date *

yyyy mm dd

Relationship to Applicant (if applicable):

I am the *

Applicant Parent or guardian

By agreeing to the above terms, as the applicant, I am giving permission to OFCP staff to process this application accordingly *

I agree and give permission to process this application

By agreeing to the above terms, as the applicants' parent / guardian, I am giving permission to OFCP staff to process this application accordingly *

I agree and give permission to process this application

If any information is missing or the application is incomplete, the applicant or primary contact person will be notified for completion and submission of missing information. If we do not hear from the applicant within two weeks the application will no longer be active.

If you require additional information regarding this application or have any questions please contact:

Ontario Federation for Cerebral Palsy
416-244-9686 ext: 221 or toll free 1-877-244-9686 ext: 221
Email: leaf@ofcp.ca Website: www.ofcp.ca

Supplemental LEAF Application Forms

(These forms may need completing after your application is approved)

Physical Support Services Form - If you applied for financial assistance to help you pay for support services and have received a formal approval letter from OFCP, please complete this form as proof of purchase and submit it to OFCP for payment processing purposes by email to leaf@ofcp.ca or (preferred) attach it to this application (below)

Sample Receipt required information - If you applied for financial assistance to help you pay for support services and have received a formal approval letter from OFCP, please complete this form as a proof of purchase for services provided to you by a private service provider and submit it to OFCP for payment processing purposes by email to leaf@ofcp.ca or (preferred) attach it to this application (below)

Attach documents to submit with your application here *

Browse For Your Files

ONLY ATTACH RECEIPTS, INVOICES OR QUOTES HERE.

Complete this application form in full. Attach all required documentation. Incomplete applications will be returned.

Please note: Attach ALL documents to this online application BEFORE you click submit below, including the direct deposit information at the top of this application.