District of Highlands, BC - Official Website

Application for Grant in Aid

First Name
Last Name
Date
Street Number
Apt #
Street Name
City
Province
Postal Code
Phone Number
Fax
Email
Alternate Contact
Alternate Contact Number
Organization
Date of Incorporation
Date of Registration
Society Act Registration Number
Revenue Canada Charitable Registration Number
Board of Directors
Geographic Area Served by Organization
Members in Good Standing
Highland Members
# of Full-Time Staff
# of Part-Time Staff
# of Volunteers
# of Volunteer Hours
# of Clients Served Last Year
# of Clients Served this Year (Projected)
# of Highland Residents
# of Highland Youth Residents
Current Budget
Income
Expenses
Requested Grant
Provide a brief history of your organization
Objective / mission statement of your organization
Services and/ or facilities your organization has provided in the District
What is the intended use of the funds
List of organizations contacted and amount of requested funds
Describe your project or special event date, its objective and its budget
Has your organization applied for a grant from the District previously
1. YES
2. NO
If yes please provide details
Project | Year | Funding Received
Provide a brief summary of the benefits of your project which are directly or indirectly going to affect our District residents
Details relative to recent efforts your organization has made to make it self-supporting
Does your organization wish to make a presentation to Council
1. YES
2. NO
If yes - provide contact information
Attach Documentation
Only attach information that cannot be included in this form - such as financial statements. Thank you.
Electronic Signature
Title / Position
Date
Do you agree?*
By clicking "I agree," you agree and acknowledge that 1) your application will not be "Signed" in the sense of a traditional paper document and 2) By signing in this alternate manner, you agree that your electronic signature is valid and binding upon you to the same force and effect as a handwritten signature.
1. I agree