Online Grant Application Form

Section 1: Contact Information

Organization Legal Name Required

Organization Mailing Address Required

Contact Person 1:

Contact Name Required

Contact Email Address Required

Contact Phone Number Required

Contact Person 2:

Contact Name

Contact Phone Number

Contact Email Address

Section 2: Application Summary

Project or purpose for which you require assistance Required

Amount of Grant Requested Required

To the best of my knowledge, all of the information that is provided in this application is true and correct. Furthermore, I hereby certify that this application for assistance is NOT being made on behalf of an individual, industry, commercial or business Required

I Agree

Section 3: Applicant Profile

Please describe the services/benefits that your organization provides to the community. Are these services/benefits available to the community from another organization or agency? Required

Which RDBN electoral area(s) receive services or benefits from your organization?

Electoral Area A (Smithers/Telkwa Rural)

Electoral Area B (Burns Lake Rural)

Electoral Area C (Fort St. James Rural)

Electoral Area D (Fraser Lake Rural)

Electoral Area E (Francois/Ootsa Lake Rural)

Electoral Area F (Vanderhoof Rural)

Electoral Area G (Houston/Granisle Rural)

Is your organization voluntary and non-profit?

Yes

Please detail any remuneration paid, or funds otherwise made available to members, officers, etc. of your organization.

Please comment on the number of members/volunteers in your organization and how long your organization has been in operation.

Section 4: Project/Proposal Profile

Assistance is being requsted for: Required

Capital project and/or equipment

Special event

Other purpose - please explain below

Other Purpose

Please describe the project/event for which you are requesting assistance. If you are applying for an exemption from fees and/or charges or other consideration, please provide details of your request here. Attach additional information if required.

Describe how this proposal will benefit the community.

Section 5: Funding and Financial Information

Attach supporting financial information, ie: budget/financial report. Ensure all information is clearly itemized, including: total cost of project, grants/funding from other sources, funding contributed by applicant, total expenses for the fiscal year.

Drag & Drop Files Here

Have you applied for a grant/funding from other source(s)?

Yes - please provide information below

Name of Grant or Funding Agency

Amount applied for

Status of application

Approved

Denied

Pending

Name of Grant or Funding Agency

Amount applied for

Status of application

Approved

Denied

Pending

Name of Grant or Funding Agency

Amount applied for

Status of application

Approved

Denied

Pending

Has the organization received assistance (grant in aid/waiving of fees, etc.), from the Regional District of Bulkley-Nechako in previous years? Required

Yes

Unknown

If yes, please provide the year, the amount, and the purpose for the assistance.

Does your Organization: (Please check all that apply)

Offer direct financial assistance to individuals or families?

Duplicate services that fall within the mandate of either a senior government or a local service agency?

Provide an opportunity for individuals to make direct contributions?

Is your organization part of a provincial or national fundraising campaign?

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Grant in Aid Online Application

NOTE TO APPLICANTS

Contact Person 1:

Contact Person 2: