PD Funding Form

Training: Kimochis Virtual May 2023
Hours Completed: 12 hrs
Date: May 2nd, May 9th, May 16th, May 23rd May 30th, June 8th
Location: Zoom

Date: _____________________________
Cheque #: _________________________
Amount: __________________________
Initial #1: _______ Initial #2: ______

The Alberta Home Visitation Network Association (AHVNA) will provide funding for the time spent on designated Professional Development (PD) training This form will be used to determine eligibility for PD time at a rate of $17.50 per hour. If the Early Childhood Educator is determined eligible upon confirmed completion of required hours and completion of this form AHVNA will issue a cheque.

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Personal Mailing Address
First time attending this training?
Ages you work with primarily?


The following conditions apply to this PD form:

  1. The PD funds are not approved until the training has been completed, and hours have been confirmed.
  2. Prior to having fully completed the hours committed, there is no agreement between the parties, and the Alberta Home Visitation Network Association has no obligation to provide the PD funds.
  3. All information contained in this form is true and accurate.
FOIP Declaration:
All information provided by the parties will remain private and confidential.
Signature of the Person Submitting this Form
Name of the Person Submitting this Form