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BALDING FOR DOLLARS EDUCATION BURSARY FUND
APPLICATION
Goal:
To support the advancement of knowledge, skills and education for survivors of childhood cancer or blood
disorders who are/were involved in the BC Children’s Hospital (BCCH) Oncology/Hematology/Blood and
Marrow Transplant (BMT) program.
Application Eligibility Criteria:

You must be:
o a survivor of a childhood cancer or blood disorder, or
o in treatment for a childhood cancer or blood disorder, and
o involved in the BCCH Oncology/Hematology/BMT program
 The educational program you are applying to attend is worthy of funding if it:
o Meets the goal of the bursary program
o Is sponsored by a professional association or agency
o Will enhance your life
o Will help with future employment
 You may apply for money for:
o Registration/tuition
o Books
o Course materials
o Other (will be considered on a case by case basis)
 Favorable consideration will be given to you if you:
o Have not received funding from Balding for Dollars (BFD) in the past 12 months
 If you have received funding from BFD, did you meet the expectations outlined
in the Application Form?
Note: You may apply for each deadline.
o Have contributed to BFD events or activities in your community or have signed up to
help with an event or activity.
NOTE: final decisions may be based on the date application is received. We suggest you apply
early!
You may apply for each course/session/class that meet the criteria listed above.
DEAD LINES ARE:
 JUNE 1 FOR THE SUMMER/FALL STUDIES
 NOVEMBER 15 FOR WINTER/SPRING STUDIES
There are two separate things you need to do to get funding:
1. Apply for funding. This must be approved by the BFD committee before you apply for reimbursement of
funds.
2. After you are approved for funding and have finished your course/session/class, apply for
reimbursement of the money you paid.
These 2 processes are described on the following pages.
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1. Apply for Funding:
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Complete the Application Form (below). Follow all the instructions. Incomplete/incorrect
applications will be returned.
Provide proof of acceptance to a university, college or any education program. For example, you
can send a copy of the acceptance letter or a record of the courses/sessions/classes you
registered for.
If you are in treatment, provide a statement from your doctor/pediatrician/oncologist stating that
you are medically able to attend/complete the education for which you are applying.
Send your applications to:
Suzanne Dunbar
Room B315A
4480 Oak St.
Vancouver, BC V6H 3V4
Phone: 604-875-2345, ext 2497
[email protected]
You may use regular mail or email as long as the application gets in by the deadline: June 1
(summer/fall studies); November 15 (winter/spring studies).

If you have any questions about applying for funding, please contact Suzanne Dunbar (see
above contact information)
Use this checklist to help you make sure that you have everything you need to apply for funding:

Task
Complete the application form. Do not leave any blank spaces.
Provide proof of acceptance to the school/program. For example, your letter of
acceptance.
Provide a letter from your doctor only if you are in treatment
Send all the above to Suzanne Dunbar before the deadline
Questions? Contact Suzanne Dunbar for questions about applying for funding.
Note: If you need help filling in this application, please check with your social worker or
Suzanne Dunbar (Patient/Parent Advocate) by phone: 604-875-2345 extension 6477 or by email:
[email protected]
How Funding Will Be Granted:
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There will be 2 deadlines/year: June 1 (for the Summer/Fall courses) and November 15 (for the
Winter/Spring courses). Late applications will not be considered.
We will not fund courses/sessions/classes that you took before the deadline, only courses you will be
taking in the days/weeks/months after the deadline.
Decisions about funding will be made soon after the deadline.
A maximum of $1000 Canadian may be awarded to each applicant. A separate application form is
required each time you apply for funding.
The Education Sub-Committee will consider the criteria listed on the first page when making decisions
about funding. They will respond to applications within 14 business days after the deadline.
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BALDING FOR DOLLARS EDUCATION BURSARY FUND
APPLICATION FORM
Applicant Information:
Name
I am (check all that apply):
□ a survivor of childhood cancer or blood disorder
□ in treatment for a childhood cancer or blood disorder
□ involved in the BCCH Oncology/Hematology/BMT program
Phone number (W)
(H)
Email:
Mailing Address:
Tell Us About Your Education:
What will you be studying?
What school/program will you be attending?
Description of Costs/Expenses (in Canadian Funds)*
Total
Expense
Registration/Tuition:
Books:
Course materials (specify):
Other (specify)
Total Expenses:
*Note: only acceptable expenses will be reimbursed.
THIS IS FOR THE COURSE/SESSION/CLASS/TERM/SEMESTER/LEVEL, ETC. THAT YOU ARE PLANNING TO ATTEND IN
THE NEXT FEW WEEKS OR MONTHS. IT MAY BE ASSOCIATED WITH A PAYMENT SCHEDULE. IT DOES NOT MEAN 612 MONTHS OR MORE. FOR EXAMPLE, FOR THE JUNE 1 DEADLINE, APPLY FOR EXPENSES YOU WILL HAVE FOR
THE SUMMER OR FALL; FOR THE NOVEMBER DEADLINE, APPLY FOR EXPENSES YOU WILL HAVE FOR THE WINTER
OR SPRING.
Goals for attending this education/course: Why do you want to attend this education/course?
Have you received funding from BFD to attend any other education in the last 12 months?
Yes□ No□
Have you contributed to BFD in the past? Yes □
How?
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No □
3
How do you intend to contribute to BFD?
(For example, you can post/distribute promotional material in your workplace, school or someplace else;
advertise an event; volunteer at an event; shave, fundraise, etc.)
If you are in active treatment:
My doctor has agreed that I can take this course.
Yes□ I have attached a letter from him/her.
□
I have attached proof of acceptance from the educational institution to attend this course/education.
If I get funding I agree to:
 Report back to the BFD committee within 3 months of completing the education for which you
received the funding.
 Contribute to BFD in my community/workplace. I understand that I may get promotional material and
requests to participate in fundraising via email
Signature_____________________
Date: ________
Check one:
This application is for the
□ June 1 deadline (for summer/fall courses)
or
□ November 15 deadline (for winter/spring courses)
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For committee use only:
Criteria
Is the application complete?
Is the applicant eligible?
Is the educational program worthy of funding?
If in treatment, is there a letter from a physician
supporting this application?
Has the applicant received funding from BFD in the
past 12 months?
If the applicant has received funding in the past,
have they honored their commitment to
participate/support/contribute to BFD?
Are the applicant’s goals clearly stated and do they
reflect the goals and mission of the program?
Has the applicant attached a letter of acceptance
from the education institution?
Yes
No
Comments
APPLICATION APPROVED for $____________
APPLICATION NOT APPROVED for the following reasons:
AUTHORIZED SIGNATURE: ______________________________
DATE ______________
Applicant notification letter sent:
□ Email
□ Other:
Date:
By whom:
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2. Apply for Reimbursement:
 Fill in the Education Bursary Report Form (next pages). Some of this information may be used
anonymously by BFD for promotional purposes.
 Attach original receipts that have your name on them for expenses. You may submit printed,
electronic receipts as long as they have your name on them.
Note: our Finance Department will not accept anything other than original receipts with
your name. They will not accept credit card bills/receipts. Your name MUST appear on
the receipt that you submit for reimbursement: credit card number, student number
or email address is not enough.
 Submit the completed Education Bursary Report Form and original receipts, within 3 months of
completing the education you attended, to:
Suzanne Dunbar
Room B315A, Oncology/Hematology/BMT Division
BC Children’s Hospital
4480 Oak St
Vancouver, BC V6H 3V4
Phone: 604-875-2497; Fax: 604-875-2911
Email: [email protected]
Note: if you do not submit the above for reimbursement within 3 months after your
course/session/class is finished, we will assume that you are not using the bursary and will
allocate these funds to someone else.
 Incomplete submissions will be returned.
 If you have any questions about getting your reimbursement, contact Suzanne Dunbar (contact
information above)
Use this checklist to make sure that you have everything you need to apply for reimbursement once you
have been approved for funding and you have finished your course/session/class:

Task
Complete the Education Bursary Report form.
Gather original receipts with your name on them.
Send all of the above documentation to Suzanne Dunbar within 3 months of
completing the course/session/class.
Questions? Contact Suzanne Dunbar (contact information above)
Expectations of Applicant:
 Report back to the BFD committee within 3 months of completing the educational program. (see
attached Education Bursary Report Form) This information may be posted anonymously on the BFD
website.
 Contribute to BFD in your community/school/workplace. This may be posting/distributing promotional
material in your workplace, school or someplace else; advertising an event; volunteering at an event;
shaving, fundraising, etc. Your email will be added to our email list so you can get promotional material.
You can also go on the BFD website for more information about events and activities:
www.baldingfordollars.com
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Education Bursary Report Form
(Submit when you apply for reimbursement only)
Name:
Mailing Address:
Phone Number:
Email:
Course/Education:
Dates attended:
Were your goals for attending this education met: Yes:
How?
No:
What are 3 things you learned?
How will you contribute to BFD? (For example, you might post/distribute promotional material in
your workplace, school or someplace else; advertise an event; volunteer at an event; shave;
fundraise, etc)
Is there anything else you’d like to tell us?
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