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Financial Support Program for a Youth

Pour le français, cliquez ici.

PLEASE NOTE: You may only submit one request per level (Atlantic, national, international) per year.

Name

Address

Telephone

When did you begin residing in Dieppe?

Are you registered in a full-time studies program?

Yes

Type of request

Cultural: Activity related to the arts, music or heritage

Sport: Activity related to sport and competition

Name of event

Date of event

Location of event

At what level is the event taking place?

Atlantic

National

International

Was selection or qualification necessary in order to participate in this event? If yes, please supply a copy of the correspondence received that indicates you are qualified or have been selected.

Yes

Please sent proof of participation (photo, accreditation, etc.) or proof of payment (plane ticket, etc.).

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Personal information on this form is collected under the authority of the Right to Information and Protection of Privacy Act and the Personal Health Information Privacy and Access Act for the purpose of processing your application. Personal information will be used to determine your eligibility for programs offered by the City of Dieppe insofar as issuing a profile number is concerned. It will also be used to communicate with participants if authorization is given. Questions about this collection of personal information can be directed to the Clerk, 333 Acadie Avenue, Dieppe, New Brunswick, E1A 1G9, 506.877.7900.

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