This completed application form will be submitted to wellness@srteach.org

All fields required.
Note: If planning more than one activity for the school, please submit once per activity.

Applicant:

Applicant email:

Application Date:

Title of Activity:

Date of Activity:

School/workplace:

Committee Members (in consultation with staff and SRTA council representative):

Activity Description:

Physical Wellness Component:

Nutritional Wellness Component:

Mental Wellness Component:

Where:

Total amount requested: $

Cheque Payable to:

(if more than one recipient, please email wellness@srteach.org and let the Chair know)