LELF Application

Thank you for applying for the Canada FASD Research Network Lived Experience Leadership Fund. Please read the fund guidelines to make sure that you qualify before completing this application. Also note, that you will need a letter of support from a research leader with this application.

Applications are due April 1, June 1, September 1, and January 1 and reviewed by the end of these months. Notification will be sent out to applicants within two (2) weeks of a decision.

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Is this application for more than one person? *

Yes
No

What is the event or research activity you are attending? *

What are the dates of your event or research activity?

First day:

Last day:

Are you presenting at this event? *

Yes
No
Abstract submitted and awaiting decision

Provide a letter of support from a Canadian Research Project leader that includes their contact information. *

Click or drag a file to this area to upload.

Why is important for you to participate in this research activity or event? *

Provide a description of what you will use the LELF funds for: *

Total amount of funds requested: *

What is the best way for you to receive funds: *

e-transfer
cheque
other

Do you have any other funding or supports for this project/request? *

Yes
No

Provide a detailed budget of the funds you require:

Flights

Food

Accomodations

Support person costs

Conference/event registration

Other

Travel in town (taxi, Uber, etc.)

If you are a person that requires support to attend events, share with us how this will be provided for in this project.