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Grant Application Final 2015

The organization is applying for a $ grant from the Brandon Area Community Foundation (BACF). If approved, the funds would be used for a project starting on date and ending on date. The organization provides services to target populations within a certain geographic area, serving a number of people. It is requesting partial or full funding for the project. The application includes details on the project, funding sources, evaluation plans, and recognition of BACF. It also provides references and required documentation for the application.

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Carlos
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98 views4 pages

Grant Application Final 2015

The organization is applying for a $ grant from the Brandon Area Community Foundation (BACF). If approved, the funds would be used for a project starting on date and ending on date. The organization provides services to target populations within a certain geographic area, serving a number of people. It is requesting partial or full funding for the project. The application includes details on the project, funding sources, evaluation plans, and recognition of BACF. It also provides references and required documentation for the application.

Uploaded by

Carlos
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Page 1

GRANT APPLICATION
AGENCY PROFILE:
Organization Name:
Primary Contact:

Position:

Address:
Postal Code:
Fax:

Phone:

Email:

Charitable Registration No.


Date of Incorporation:

Agency Website:

Number of Employees: Full time

Part time

Volunteers

Previous Grants: Please list previous grants received from the Brandon Area Community Foundation
Date:

Purpose:

Was Final Grant Reports Filed:

Amount:

YES

NO

AGENCY INFORMATION
1. What is the purpose of the organization?

2 What services are provided? - Include target population, geographic area served, and number of
people served.

Page 2

GRANT REQUEST
Amount Requested: $

Total Cost of Project: $

Project Start Date: ____________________ Completion Date: _________________________


Will the funds be spent within the following year?

Yes

No

1. Project Description: (attach separate schedule if nessecary)

2. Source(s) of Funding
Please identify other sources of funding for this project.
Pending

Confirmed

Pending

Confirmed

Pending

Confirmed

3. Partial Funding
Would your organization be able to continue the initiative if you were to receive only partial
funding in support of your request?
No
Yes
If no, please explain:

4. Is your local Community Foundation a Funding Partner?


If Yes, elaborate:

If No, please explain:

Yes

No

Page 3

5. How will this project be evaluated?

(attach schedule if necessary)

6. How will you recognize recognize BACF and other Project Partners?
Media ready story
Photography
Signage/Banner
Other

COMMUNITY REFERENCES
Please provide the name, address, telephone number and contact person for three organizations who may
be contacted by the Brandon Area Community Foundation in support of your organization's application for
funding.

Name:

Contact Person:

Address:

Phone#:

Email:
Name:

Contact Person:

Address:

Phone#:

Email:

ATTACHMENT TO BE INCLUDED
Please check off items to ensure that you have included all required documentation to complete your
grant application.
Grant Application Form
Annual Report
Most current Audited or reviewed Financial Statement
Total revenue and expense budget for current year
Budget for proposed project
Detailed application proposal
List of Current Board Members
Photocopy of a void donation receipt or copy of agency agreement re: CCRA Registration Number
AUTHORIZATION
This application must be signed by two Officers of the organization's Board of Directors.
(Chair/President, Vice-Chair/Vice-President or Treasurer - By signing this application the applicant agrees to the
grant terms and conditions and gives BACF permission to publish photo's, grant recipient stories, and grant info upon
approval of the grant. Grant applications, which are not approved, will remain confidential.)

Name and Title (print)

Signature

Phone #

Date

Name and Title (print)

Signature

Phone #

Date

Completed application and required supporting documents must be received by BACF


no later than Sept. 30!

Brandon Area Community Foundation


Mailing Address: Unit 5A, 457-9th Street
Box 22096 Brandon, MB R7A 6Y9
For more information: Laura Kempthorne, General Manager
Phone : (204) 571-0529 E-mail: [email protected] Website: www.bacf.ca
Any personal information requested on this application will only be used to assist with the assessment of your grant application

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