Online application for Recreation and personal development funding

As a BWA Member, you may be eligible to access BWA funding assistance for you to participate in a Recreation or personal development program.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Are you a BWA Member ?*
- I am a BWA Member
- No
- I would like to be a BWA member
Are you legally blind?*
- Yes
- No
My goal/plan is to:*
Year and Term of Programs/activities you wish to attend*
Details of the Programs/Activities*
Name of the program/Activity Location/provider Start date End date Hours per session Day of Week Weekly/Fortnightly/Monthly
Name of the person who referred the program/activity*
Phone
Member's endorsement*
- I apply for funding and give permission for both the RSB and BWA to share information about this joint program
Date*
DD dot MM dot YYYY
Training Details*
Course fees for the term/Session Business Name Phone Address ZIP / Postal Code
Contact Person*
Once you submit your form by using the button below you should be presented with a confirmation page. If you do not see the confirmation page, there is an error in your form. Errors will be highlighted.

Name of the program/Activity	Location/provider	Start date	End date	Hours per session	Day of Week	Weekly/Fortnightly/Monthly