Event Application Form

Thank you for your consideration in applying for event support funding from your Nanaimo Medical Staff Engagement Society (NMSES). NMSES is funded by the Specialists Services Committee’s Facility Engagement initiative.

IMPORTANT: Please note that this application is for ONE event. If you are applying for more than one event, please use the Project Application form.

    Applicant Information

    Event Information



    Organizer Cost:
    The Physician Lead may receive a maximum of 4 sessional hours for the planning and execution of this event at an hourly rate of $171.05/hr
    Attendees will not be paid sessional time.
    Please note that all sessional and reimbursement claims must be submitted within 3 months from date of occurrence.




    Physician Lead:
    Total hours: @ $171.05/hour


    NMSES Admin Costs: @ $30.00/hour


    Event Space Costs:


    Catering Costs:


    Other Costs:


    Total requested for this Event


    Sign and Date

    I agree