BC CENTRE OF EXCELLENCE FOR YOUNG INDIGENOUS LEADERS
APPLICATION FORM
BC Aboriginal Youth Leadership Training Symposium
June 8 - 12, 2015
Hosting City Victoria, BC
APPLICATION REQUIREMENTS:
1. Applicants must be between 19-30 years of age and be of Indigenous ancestry (including status, non-status, First Nations, Métis, and Inuit).
2. Must live in the BC Region or the Yukon.
3. Applications must be received by Thursday April 30th, 2015 in order to be considered.
4. All completed applications can be sent to:
Mail: / Email: / Fax:3244 Doncaster Drive
Victoria, BC
V8P 3V5 / / 1-250-388-5502
Please note spaces are limited. Spaces for each age group, gender, and geographical region may be limited to ensure a diverse representation of participants.
Registration fee:
A $50 registration fee will be required from each participant upon acceptance to the program. This fee must be received by May 18, 2015.
Tuition fee:
The tuition fee for the June 8-12, 2015 training symposium is $2,500** per participant.
This fee includes: Travel (including airfare), hotel, opening and closing ceremonies, books and course material, and most meals. Travel arrangements will be coordinated by the BCCEYIL.
**Those applicants who register for the training symposium and pay the tuition fee will be guaranteed a seat in the program.
**Please note, we do have fully sponsored seats for this training in which the fee is waived. Please indicate if you are seeking a sponsored seat. In this case, you must submit your application form for review and your application will be considered. Not all those applying for sponsored seats will be successful.
ü Please check one of the following:
_____ I am applying for a sponsored seat and for the tuition fee to be waived.
_____ I will pay the tuition fee and secure a guaranteed seat in the Program.
Accommodation:
The hotel accommodations will be at the Four Points by Sheraton Victoria Getaway, Victoria, BC
Training Facilities:
The training will take place at Royal Roads University in the Blue Heron House (Sneq’wa e’lun)
BC CENTRE OF EXCELLENCE FOR YOUNG INDIGENOUS LEADERS
APPLICATION FORM
BC Aboriginal Youth Leadership Training Symposium
June 8 - 12, 2015
DATE: ______
Personal Information:
(Note: All information given is for the use of application process only and is protected under the BC Information and Privacy Act)
****Please print clearly****
NAME (please print): ______
Birth Date (Month/Day/Year: ______/_____/______AGE: ______
CONTACT INFORMATION:
MAILING ADDRESS: (Street, Town/City, Province/Postal Code)
______
______
TELEPHONE NUMBERS:
Home: ______
Work: ______
Cell: ______
EMAIL ADDRESS: ______
INDIGENOUS ANCESTRY/BAND/NATION: ______
CONTACT NAME/PHONE NUMBER: ______
BAND/NATION: ______
BC CENTRE OF EXCELLENCE FOR YOUNG INDIGENOUS LEADERS
The following information is required and the more detailed information you can provide will help support our selection process.
1. Community Role:Please write a one to two page description of your role and how you provide services back to your community and/or organization and attach it to your application.
2. Character References:
You must provide TWO character reference letters from an employer, teacher, counsellor, Elder, or from someone from an Indigenous organization (Letters by relatives not accepted). References letters can be sent to 3244 Doncaster, Victoria, BC, V8P 3V5 or via email, . Due to the high number of applications, we are unable to accept telephone reference calls.
If the reference letters are not received by April 30, 2015 your application is not complete and it will not be considered.
1.
2.
3. Education Information:
School/College/University:
Certificate: / Level Completed:
Graduate Date:(if applicable) / Degree:
4. Employment Information:
Company/organization:
Position/Title:
Supervisor:
Describe Work Responsibilities/Ethics:
5. Leadership Role:
Company/organization/community:
Position/Title:
Describe leadership/governance responsibilities:
The following is to ensure you have read and understand the registration fee, tuition fees, travel, accommodation, and the training facilities information:
Registration fee: (initial) ______
A $50 registration fee will be required from each student participant upon acceptance to the program. This will need to be received by May 18, 2015.
Tuition fees: (initial) ______
The Tuition fee for the June 8th-12th, 2015 Training Symposium is $2,500 per participant. This fee includes: Travel (including mileage and/or airfare), hotel, opening and closing ceremonies, books and course material, and most meals. Travel arrangements will be coordinated by the BCCEYIL.
Accommodation & Travel: (initial) ______
The hotel accommodations will be provided at the Four Points by Sheraton Victoria Getaway, Victoria, BC. The BCCEYIL will coordinate all hotel bookings for training participants. Travel costs included in the tuition include: airfare and/or mileage from your home community to Victoria; return transportation from the Victoria airport to the host hotel; a shuttle from the host hotel to the training facility each day. Extra taxis and other additional transportation costs are not included in the tuition fee and will not be reimbursed.
Meals Information: (initial) ______
Breakfast and lunch will be provided each day from Monday to Friday for the duration of the training program and dinner will be provided on Wednesday evening. All participants are responsible for their own dinner on Monday, Tuesday, and Thursday evening. The hotel has a full service restaurant on site and there are a number of restaurants within walking distance.
Food allergies: (initial) ______
We will do our best to accommodate any food allergies. If you have any concerns, please contact the Program Director at: or Phone: 250-882-0922.
BC CENTRE OF EXCELLENCE FOR YOUNG INDIGENOUS LEADERS
Participant Signature:
Please sign below to acknowledge that the information on this application is true to the best of your knowledge and that you understand the following:
1. Attendance each day is mandatory. If you decide to leave the training early, you will be responsible for your travel costs.
2. The BCCEYIL reserves the right to refuse further participation to any participant for any inappropriate behavior and/or failure to respect the program rules and regulations.
3. You have sent in a completed application along with two references letters.
4. Upon acceptance, you will submit the registration fee ($50) to the address below.
5. You have read and understood the BCCEYIL tuition, travel, and accommodation fee information.
Sign: ______Date: ______
DEADLINE FOR APPLICATIONS: April 30, 2015 at 4:00 pm
Send completed applications to:
Program Director
3244 Doncaster Dr, Victoria, BC, V8P 3V5
email:
fax: 250-388-5502
Accepted participants will be notified by
May 8, 2015
An information package with all the training details will be e-mailed upon acceptance to the program.
OFFICE USE ONLY: / Notes:Date Received:
Signing Officer:
Accepted:
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