1 Start 2 Complete Are you working towards a goal but there’s an expense getting in your way? The Reach for Success Bursary can provide you with up to $500 to overcome barriers you might face in achieving your goals. Reach for Success Bursary winners have used the money to pay for photography lessons, driving lessons, yoga memberships, sports team fees, technology, Canadian citizenship applications, BCIDs, certifications like FoodSafe and Serving it Right, and even dental work. If you need money for anything you don’t see listed here, get in touch with us and we’ll do what we can to help! NOTE: This bursary will be sent directly to the program/activity. It cannot be released directly to successful applicants. Bursary money can take up to 6 weeks to reach the designated organization. Post-secondary courses and supplies will not be accepted – please see our Education Achievement Bursary. Eligibility You are a youth in care or former youth in care in BC You have a cumulative total of 1 year in government care (CCO, VCO, TCO, SNA, YAG, Extended Family Placements) You are between the ages of 14-24 Please download our handy checklist to make sure you have everything you need before you start the form. You will not be able to save the form and come back to it. If you have any questions, please contact Taylor at taylor.burnett@fbcyicn.ca. Personal Information First Name * Last Name * Legal First Name (if different from above) Legal Last Name (if different from above) Date of Birth * Year Year1900190119021903190419051906190719081909191019111912191319141915191619171918191919201921192219231924192519261927192819291930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Pronouns She/Her She/They He/Him He/They He/She/They They/Them Self-Described If you marked your pronouns as 'self-described', please add your pronouns here Gender Female Male Non-Binary Two-Spirited Other If you marked your gender as 'other', please add your gender here What's your experience in care in BC? (mark all that apply to you) * When we talk about care experience at the Fed, we mean that at some point between the ages 0 and 19 you had accessed services from the Ministry of Children and Family Development or a Delegated Aboriginal Agency. This includes Foster Homes, Group Homes, Child and Youth Mental Health Services, Addiction Facilities, Community Living BC, Custody Centres, Youth Agreements, Independent Living Agreements, Extended Family Placements, or Homelessness. If you're not sure about your care experience, you can mark "I don't know," and a staff member will follow up with you. Foster Homes Group Homes Youth Agreements Independent Living Agreements Extended Family Placements Homelessness Youth Justice Residential Treatment or Support Centers I don't know Do you identify as being a member of any of the communities below? Check all that apply to you. Indigenous LGBTQ2S+ Disabilities Newcomer to Canada (immigrant, refugee, 2nd generation) Parent Other If you marked your community as other, please share it here. If you identify as Indigenous and you would like to share your ancestry or what nation you belong to, please feel free to. Contact Information Email Address * Phone Address Line 1 Address Line 2 Include any unit number or PO box. City * Province * Postal Code What is the best way to contact you? * Any Email Phone What are you requesting funds for? Tell us about the program, service or activity you want to do. Name of program/service/activity * What is the total cost? * If the total cost is more than the Reach for Success Bursary max amount ($500), do you have a plan for how you'll cover the rest of the cost? Yes No If yes, what is your plan? How will this bursary benefit you? * Please provide a paragraph or two. Supporting Documents Please attach the documents below. Be sure to hit 'Upload' after you select the file or it will not attach. Reference Letter * From a teacher, advisor, counselor, worker, employer, family member or other supportive person. The letter should be from within the last year or so.Files must be less than 2 MB.Allowed file types: jpg jpeg png txt pdf doc docx odt. Proof of Care Letter * From the Ministry of Children and Family Development or Delegated Aboriginal Agency to confirm your care status and time in care.Files must be less than 2 MB.Allowed file types: jpg jpeg png txt pdf doc docx odt. Please attach a letter, screenshot or photo with the information about your program/service/activity * The image can be from a website, brochure or other source of information about the program/support/professional.Files must be less than 2 MB.Allowed file types: gif jpg jpeg png pdf doc docx. You can also include a link to a website. How did you hear about the Dream Fund Bursary Program? * Fed presentation Fed website Fed social media channel Social worker Other How did you hear about the Dream Fund Bursary Program? * Acknowledgements Would you like to hear from us about opportunities and resources? Let us know if you would like to receive emails from us on opportunities, information and resources offered by the Fed and other youth-serving organizations around BC! Yes, please sign me up for your e-newsletter. Become a Fed Youth Member! Join the Fed! Youth members have priority access to all the great opportunities the Fed has to offer, they are part of our provincial family, and they help to create a better experience for their care siblings. Only youth members can vote on key decisions we have to make as an organization. You’ll influence all of thing things we do! Membership is free and open to youth in and from government care in BC between the ages of 14 and 24. Yes, contact me about signing up. Informed Consent * By checking the box below, I confirm that the information that I have provided is true. Should any part of the information included in this application package change for any reason, I agree to immediately notify the Dream Fund Selection Committee of these changes. I also consent to the Dream Fund Selection Committee verifying that I have been in the care of the Ministry of Children and Family Development or Delegated Aboriginal Agency. Yes, I consent (youth) Yes, I consent (guardian if youth is 18 or under) Media Release By checking the box below, I consent to allow my name (first name, last name initial) to be published in any Fed media and publications, including but not limited to Power Pages, a magazine that is distributed provincially to youth in and from care and service providers, and a program report. Yes, I consent Fed Policies * Please review the key policies related to our programs and services linked below. I have reviewed, understand, and agree to the Fed Policies I would like staff support to review the policies with me Read our Fed Policies here. Privacy and Information Consent * We are collecting your personal information here to process your application for an Education Achievement Bursary, to contact you about your application, and to invite you to participate in a program evaluation. By marking ‘Yes, I consent’ below, you give the Federation of BC Youth in Care Networks permission to collect and use your information as we described above. If you have any questions or need more information, please contact info@fbcyicn.ca. Yes, I consent.
