SAOT/COTF Continuing Education Bursary

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Employer(Required)

SAOT Membership #(Required)

ACOT Registration #(Required)

Letter of Intent (250 word maximum)(Required)

Briefly describe the chosen continuing education opportunity and how participation will support you in providing excellence in direct client care in your current practice. The Letter of Intent should be no more than 250 words and should clearly outline the intended and anticipated impact on your practice, such as creative implementation of new ideas, solutions, equipment or products to improve client care.

Will you be receiving any other sources of funding?(Required)

Yes

Please identify any additional sources of funding you are receiving