Please take 5 minutes to fill out the form.
Instructions: Please complete this form to provide the necessary information for Burning Arrow to submit a Jordan's Principle funding request on behalf of your child. This information helps us confirm eligibility and process the request efficiently.
If you are completing the form for two or more children please email josh@burningarrow.ca with the names of each child along with the same info you fill in for the first child along with the status card photos.
If you require any help please email josh@burningarrow.ca
1. Purpose of Agreement
The purpose of this Agreement is to grant Burning Arrow permission to act as an authorized representative to submit a funding request under Jordan's Principle on behalf of the child(ren) named above, who ordinarily reside on reserve, for services and supports related to the community youth archery program. This program is intended to enhance youth well-being through cultural, recreational, and educational activities that foster leadership and community connection.
2. Authorization
I the undersigned, hereby authorize Burning Arrow to act as a representative for the purpose of requesting funding, services, and supports through Jordan’s Principle. This authorization includes the authority to:
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Collect and submit required documents for the Jordan's Principle request.
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Communicate with Jordan's Principle representatives, Indigenous Services Canada, and other relevant agencies on behalf of the undersigned.
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Advocate for and secure resources necessary for the youth archery program, including equipment, instructional materials, and coaching/training fees.
3. Description of Requested Services
Under this Agreement, Burning Arrow may submit requests for services and supports for the archery program, including, but not limited to:
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Program-related transportation and logistical needs.
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Equipment and materials necessary for safe and effective archery instruction.
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Resources for archery coaching and program facilitation.
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Other educational or therapeutic resources that benefit the physical and mental well-being of participating youth.
4. Term of Agreement
This Agreement shall remain in effect from the date of signing until the completion of the funding application process or until revoked by the undersigned in writing.
5. Consent
By signing this Agreement, the undersigned parent/guardian provides written consent for Burning Arrow to act on their behalf. The undersigned also agrees to provide any additional information or documents requested by Jordan’s Principle representatives to support the funding application.
6. Revocation of Authorization
The undersigned may revoke this authorization at any time by providing written notice to Burning Arrow. Such revocation will not affect any actions taken prior to receiving the revocation.
Thank you for helping to create opportunities for younger generations.
Burning Arrow Founder
Harold J. C. Angeconeb
