Jen Higgins Fund

THE ALPINE CLUB OF CANADA

JEN HIGGINS FUND

APPLICATION FOR FUNDING
This is the only form which can be used when applying for the ACC Jen Higgins Fund. Once you begin filling out this form your data will be saved at this url for ONE WEEK. Bookmark this page and return to it anytime within ONE WEEK to complete the form.

If your application is not fully completed it will be returned for completion to ensure our volunteer committee can properly assess all applications.

Please note the Selection Committee strongly prefers receiving applications in electronic format.
Project Title*
Amount applied for from ACC Jen Higgins Fund*
in CAD funds please
TEAM MEMBERS

Please tell us a bit about your team.

Applicant #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Current Occupation*
Age*
ACC Membership #
Must be a member of the ACC to be awarded the grant, however you may add this information at a later date if you do not have it currently.

Resumes
For each applicant and team member listed above, attach a brief resume outlining relevant outdoors training, certifications and experience. Also include a very brief summary of education and recent employment experience.
Applicant #1*

Upload a File

Cancelof
Applicant #2

Upload a File

Cancelof
Applicant #3

Upload a File

Cancelof
Applicant #4

Upload a File

Cancelof
Applicant #5

Upload a File

Cancelof
If your project has other team members please email their information to the Alpine Club of Canada National Office at officemanager@alpineclubofcanada.ca and it will be added to your application.

Project Details
Project Location(s)*
Project Start Date

MonthDayYear
Project Duration
Total Project Expense*
What is the objective of your project?*
Describe your project, including details of activities, method of travel, and itinerary. Maps may also be included below.*
Maps (optional)

Upload a File

Cancelof
Additional Maps (optional)

Upload a File

Cancelof
What do you see as the value of your project? For example, to your community, other women, preservation of the environment etc.*
How do you intend to share the benefits of this project with a local, regional, national, or international audience? Include details of your post–trip communication plan.*
Outline the role(s) each applicant or team member will assume during the project.*
Please briefly outline the specific experience, training and skills each participant has that will allow this project to be completed successfully and safely
How will undertaking this project assist you in meeting your career or outdoors goals?*
Is there any related information you would like the selection committee to know?

Funding
Please attach a detailed budget clearly indicating:

1. All expenses

2. All expected revenues and sources of revenue (other grants, awards etc)

3. Total cost of the project

4. Total amount requested from the ACC.
Budget*

Upload a File

Cancelof
BY CLICKING 'SUBMIT' I CONFIRM THAT, TO THE BEST OF MY KNOWLEDGE, ALL INFORMATION IN THIS APPLICATION IS ACCURATE. IF MY APPLICATION IS SUCCESSFUL, I AGREE TO ABIDE BY THE AWARD CONDITIONS STATED IN THE "AWARD RECIPIENT RESPONSIBILITIES" SECTION ON PAGE 4 OF THE APPLICATION INFORMATION PACKAGE.
Should be Empty:

THE ALPINE CLUB OF CANADA