1 Start 2 Complete You will not be able to save an unfinished form and come back to it. Make sure you have about an hour (estimated time) to spare and all the required documents (listed on the Take the Wheel page under Driver Training Bursary) ready to attach before you start filling out the form. Accepted file types are gif jpg jpeg png txt pdf doc docx odt. First Name * Last Name * Birth Date * Year Year19931994199519961997199819992000200120022003 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Age * My gender is: * My pronouns are (ie. she/her/hers): Address * City * Province * - Select -ABBCMBNBNLNSNTNUONPEQCSKYT Postal Code * Phone * Email * What's the best way for us to contact you (phone, email, Facebook, etc.)? Do you identify as status, non-status, Metis, Inuit, or self-described? Care Status Information Please describe your most recent care status with MCFD or Delegated Aboriginal Agency. * Continuing Custody Order (CCO or Permanent Ward) Temporary Care Order (TCO) Voluntary Care Agreement (VCA) Special Needs Agreement (SNA) Youth Agreement (YAG) Other If other, please specify Please list the start and end dates of your most recent care status (YYYY to YYYY) * Social Worker or DAA Worker Contact InformationPlease complete this section if you are currently in care. First Name Last Name Address City Province - None -ABBCMBNBNLNSNTNUONPEQCSKYT Postal Code Phone Email Fax Driver Training Course or Program Information Name of Driving School * What city is the driving school in? * Total Cost (you can request up to $1500) * Program or Package Name * Additional program or course information * Please attach information from the website of the course or program you want to take. Make sure it includes the name of he school, cost, and any other important information.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx odt. Essay QuestionsPlease answer the questions below in as much detail as possible and provide your answers in a single document. 1. How will receiving the Take the Wheel Driver Training Bursary positively impact your life? 2. Please explain the timeline and plan you have for successfully completing driver’s training and obtaining your N license. Include a description of your preparedness and readiness. 3. What additional supports do you feel you need to help you successfully obtain your N license? This data is collected to help us improve the program and determine other resources that could be provided. Please attach your essay answers. * Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx odt. How did you hear about the Take the Wheel Bursary program? * Fed website Fed e-newsletter Youth Retreat or other event Youth worker or social worker Power Pages Facebook Other If other, please specify Additional Required DocumentsThe following documents are required for your application to be considered complete. Copy of your L license * To prove that you have a valid L license with a minimum of 6 months before it will expire.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx odt. Proof of Care Letter * Proof of care letter stating you have a cumulative total of at least one year of experience in BC government care.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc odt. Reference Letter * Your letter can be from a teacher, advisor, employer or supportive adult in your life, stating why you would be a good candidate to receive the Take the Wheel Driver’s Training Bursary.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx odt. Guardian, Social Worker, or DAA worker Support Letter For youth between the ages of 16 and 18, a letter from your guardian or social worker confirming their support of your DriverTraining Bursary application and explaining why they cannot cover the costs of the program for you.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx odt. Applicant Declarations Informed Consent * By clicking below, I hereby verify that the information I have provided is true. Should any of the information included in this application change for any reason, I agree to immediately notify the Take the Wheel program staff of these changes. By clicking below I agree too the following if I am a successful bursary recipient: I confirm that the information I entered in this form is true. I agree to participate in an evaluation of the Take the Wheel Bursary program upon successfully obtaining my N license designation or 18 months from the date of my bursary being issued, whichever comes first. I agree to participate in check-ins every three months until I achieve my N license designation or up until 18 months from the date of my bursary being issued, whichever comes first. (Program staff will connect with you to see how you're doing) I agree to inform the Take the Wheel Program staff if at any time I am unable to complete the driver’s training program or course I am registered in within the timeframe I have agreed to with the driving school. Guardian Consent Please complete if applicant is 16-18. By clicking below I hereby confirm that the youth I am a guardian of has completed and submitted this form with my knowledge and consent. I consent. Media Release By clicking below I agree to allow my name (first name, last initial), age, city and potentially a quote to be published in any Federation of BC Youth in Care Networks publications or media including but not limited to Power Pages and a Take the Wheel Program report. If you have questions or concerns please contact us at (604) 527-7762. I agree. Guardian Consent to Media Release By clicking below I hereby give consent for the information of youth I am guardian of to be used in the above ways. I consent.