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Date of Submission:
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Name of organization
submitting grant application:
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Address:
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Name(s) of person(s) to be
consulted regarding this project:
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BC Society’s Act registration
number:
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Revenue Canada Charitable
registration number:
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Describe the focus of your
organization:
•
Seniors & Housing
•
Children & Youth
•
Heath Care
•
Education
•
Arts, Culture & Recreation
•
Community Infrastructure & Environment
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Short title of proposed
project:
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Outline of project
briefly indicating nature and objectives:
(a longer outline with supporting data may be appended if appropriate).
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List other organizations
or individuals cooperating in this project, if applicable.
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Estimated time required to complete
the project or finish the phase with which this grant would be concerned. If the proposed grant
will not complete the project, what provision is to be made for
its completion when requested funds are exhausted?
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What preparations have already
been made to undertake this project, or what facilities are now available with which to begin?
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Proposed budget for
this project, including details of proposed use of funds, types of use and
amounts:
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What other funding
for this project has been requested or committed
to date ? List source and amount.
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Total amount
requested from the Nanaimo Community Foundation:
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Signature:
_____________________ Title: _________________