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Dave Mikkelsen Award for Youth

  1. Dave Mikkelsen Award for Youth Application Form

    You are:
    - A youth 12-17 years of age who resides in Chestermere and/or area.
    - An organization that serves youth residing in the Chestermere area.
    You are providing:
    - An activity or activities supporting or enhancing the social, educational, spiritual or recreational experience and development of Chestermere Youth.
    You agree to:
    - Provide receipts to verify the expenditure of funds
    - Provide a report describing your experience
    - Attend a cheque presentation ceremony in 2019 (your picture will be taken and your name will be published).

  2. Documents can also be emailed to

  3. Consent*

  4. The personal information requested in this form is being collected for activities relating to applying for, evaluating, and awarding the annual Dave Mikkelsen Award for Youth and as such is determined to be an activity of the City of Chestermere. The personal information is collected under the authority of Section 33(1)(c) of the Freedom of Information and Protection of Privacy Act, and will be used only for the purposes identified. If you have any questions or concerns about the collection or use of information you may contact the FOIP Coordinator at City Hall, 105 Marina Road, Chestermere, AB T1X 1V7 or call (403) 207-7050.

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  6. This field is not part of the form submission.