Regional Workshop Follow-Up Form Regional Workshop Follow-Up Form Regional Workshop Follow-Up Form If you are human, leave this field blank. Basic Workshop Information Actual Expenditures Name of Workshop * Location of Workshop * Date(s) of Workshop * Workshop Contact Information Coordinator name(s) * You can enter more than one name. Please separate names with commas. Contact phone number * Fax number Email address * Mailing address * City or Town * Province * Postal code * Regional Workshop Evaluation Evaluation of the Workshop Evaluation of objectives and benefits derived from the workshop, considering inclusivity and diversity. Participants Youth (19 and under) Adult (20-54) Seniors (55+) Total Participants Staff/Volunteers Number of volunteers Approximate volunteer hours Number of instructors Number of support workers Total program/service participants Diversity Self-declared Indigenous students Self-declared New Canadians Performances Was there a public performance? yes no Number of people in attendance Geography Cities and towns in participation Please enter one town or city per line. Regional Workshop Budget (Actual) Actual Expenditures Actual Clinician Costs Professional Student Total Clinician Fees (Actual) Travel (Actual) Mileage Accommodation Taxi Parking Other Total Travel Expenses (Actual) Meals (Actual) Breakfast Lunch Supper Other Total Meal Expenses (Actual) Facility Costs (Actual) Facility Rental Other Total Facility Expenses (Actual) Administrative Expenses (Actual) Promotional/Training Supplies Transportation Costs Other Total Administrative Expenses (Actual) TOTAL EXPENDITURES (ACTUAL) Actual Income Registration (Actual) Student Adult Fees (Actual) Other Total Registration and Fees (Actual) Registration (Actual) Parent Association School Division Other Total Grants (Actual) Donations (Actual) Facilities in-kind Clinician Supplies Other Total Donations (Actual) Other Income (Actual) Self-Generated Income Request from SMEA TOTAL INCOME (Actual) Certification I hereby affirm that I am a member of SMEA in good standing and agree to abide by POLICIES, APPLICATION and FOLLOW-UP as detailed in the Regional Workshop Assistance Policy for Members. This follow-up report constitutes a correct and true statement, all required documentation is attached, and the SMEA logo and the Saskatchewan Lottery Trust logo were used on all promotional materials. Signature of applicant * If you require assistance or additional information, please contact the Saskatchewan Music Educators Association office at (306) 256-7187. Applications can be scanned and emailed to smea@sasktel.net or mailed to: The Saskatchewan Music Educators Association Box 632 Cudworth, SK. S0K 1B0 The information requested is information that SMEA is required to submit to Saskatchewan Lotteries Trust. reCAPTCHA Submit
