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Organization Details

Organization Registered Name *
Organization Email Address *
Mailing Address *
Civic Address *
Select Province *
Organization Phone Number *
Organization Website *
Organization Type *
Registration or Charitable Number

Primary Contact Information

Primary Contact Full Name
Position or Role in Organization
Contact Phone Number
Contact Email Address

Partnership Information

Is This Project a Partnership
Partner Organization Name
Partnership Agreement Document
Maximum file size: 1 GB

Project Overview

Project Title *
Project Category *
Project Description *
How Funds Will Be Used *
Project Goals *
Expected Outcomes *
Community Impact *

Beneficiaries and Reach

Geographic Area Description *
Who Will Benefit From This Project *

Impact and Sustainability

Short Term Benefits
Long Term Benefits
Supporting Evidence or Research of Community Need

Measurement and Reporting

How Will Success Be Measured *

Funding Request

Amount Requested From Grant *
Is Other Funding Being Received *
Type of Other Funding
Please specify other funding source

Budget Breakdown

Please list all start-up project costs. Do not include in-kind contributions or donated items. Provide as much detail as possible for each item to help us understand how funds will be used.

Project-specific equipment, materials and supplies
Project-specific software or other technology
Project-specific staffing
Project-specific rent or mortgage
Project-specific utilities
Project-specific travel and meeting expenses
Other project-related costs
Subtotal Direct Project Expenses:
General or administrative expenses - up to10% of project expenses
Total Project Budget:

Attachments

Quotes For Capital Purchases
Maximum file size: 1 GB
Capital projects (such as building a project hut or other construction project) must include quotes from at least 2 providers. If only one quote is provided, please explain why an additional quote was not included.
If Capital Project quotes are not included please explain why quotes were not provided
Quotes for other purchases over $5,000
Maximum file size: 1 GB
Projects that plan to obtain services or goods greater than $5,000 must include quotes from at least 2 providers. If only one quote is provided, please explain why an additional quote was not included.
If quotes for other purchases are not included please explain why quotes were not provided
If quotes for other purchases are not included please explain why quotes were not provided
Additional Supporting Documents
Maximum file size: 1 GB
for example Partnership Letters
Financial Statement *
Maximum file size: 1 GB
The Applicant Organization’s annual financial statements must be included for last year. Statements must include all revenues, expenses, assets and liabilities.
Additional Supporting Documents
Maximum file size: 1 GB

Declaration

Authorized Representative Full Name *
Position Held in Organization *
Declaration Date *
Agreement and Certification *

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