Testing form - Altona Community Foundation

GRANT APPLICATION

A: ORGANIZATION INFORMATION

Organization *

Phone *

Contact *

Email *

Mailing Address: *

No. of employees *

Charitable Tax # *

General description of agency, including population directly served and principal geographic area of service. *

Attachments required: *

A list of the organization’s executive and directors.
A copy of the organization’s budget for the current year.
A copy of the organization’s latest financial statement for the one year.
A copy of the current project plan (if available) for which this grant is being sought.

File Upload *

Click or drag files to this area to upload. You can upload up to 4 files.

Allowed file types: .png, .gif, .jpg, .doc, .xls, .pdf

B: GRANT REQUEST

Amount requested: *

Total project cost: "When projects that have been approved for a grant come in under the total project cost indicated on your grant application, the Altona Community Foundation will reduce the grant by the per cent that the project was reduced. Volunteer labour is to be excluded from total project costs." *

Project start date: *

Estimated completion date: *

C: PROJECT INFORMATION

Have you approached other sources for support? *

Describe the projects purpose and how it relates to the overall mission of the organization. *

Cite evidence of the need for the project and tell us how the project will benefit the local community. Describe any consultations with government or other agencies that relate to this project. *

How you will measure the success of the project? *

Describe the capability of your organization to conduct the project and note special staff qualifications. *

If the project is successful, what financial resources will be available for its continuation? *

How will the Altona Community Foundation be recognized for their contributions to this project? *

Has this request been authorized by your organization’ s board? *

This application must be signed by the President or another officer of the organization’s governing board.

Name *

Title *

Signature *

Clear Signature

Name of individual from whom further information may be obtained:

Name *

Title *

Email *

Please note that all successful grant applicants will have their picture posted on the Altona Community Foundation website

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A: ORGANIZATION INFORMATION

B: GRANT REQUEST

C: PROJECT INFORMATION

For today’s needs and tomorrow’s dreams.

Mailing Address: Box 2076 Altona, MB R0G 0B0

Registered Charitable # 89216 7677 RR0001

info@altonacommunityfoundation.com

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