Clinician's Professional Enrichment Grant Application Form

Thank you for your interest in the Clinician's Professional Enrichment Grant. Please fill out the required application information below.

PLEASE ENSURE ALL ATTACHMENT FILE NAMES DO NOT CONTAIN SPECIAL CHARACTERS. This includes but is not limited to  ! * # ; ? \ / : " < > |.

PLEASE NOTE that you must submit the online application, in one single step; you are not able to save your application and return to it at a future date, rather it must be completed all at one time.

Applicant Details


Practice Details


Training Details

It is expected that you will have contacted your proposed training location in advance of submitting this application.  If  funded, the Committee will require a letter from the site confirming your training program.

Proposed Budget


Required Documentation

Files must be in .pdf format.

Electronic Signature


By checking this box and typing my name, I certify that I am the person accessing this webpage, submitting this form, and that all information on this form is true and correct.  I also agree that the checkbox and my name typed below are to be used as my electronic signature. 


Please click on the "Submit" button to submit your application for the Clinician's Professional Enrichment Grant. Before submitting, please ensure you have filled out all of the mandatory fields and all attachments are correct.

Upon successful submission you will be directed to a webpage that confirms the successful submission and within a short period of time you will receive an email from the CAG National Office confirming receipt of your submission.  If this does not occur, please contact the CAG National Office.

NOTE: Upon submission do not close your browser or use the back button until the Thank You screen appears confirming your submission has been successful. Uploading of large files may take a minute or more.