.NET Framework
|About your Organization |
|Name: |
| |
|Mailing address: City: |
| |
|Postal code: Phone: Fax: |
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|Charitable registration #: Date of incorporation: |
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|BN # (if not incorporated): Organization annual budget: $ |
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|# of Employees: Full-time: Part-time: Volunteers: |
| |
|Contact person for application: Position: |
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|Phone: Email: |
|About your Grant Application |
|Title: |
| |
|Sector(s): |
|___ Arts ___ Education / Learning ___ Alleviate Poverty ___ Environmental / Conservation |
|___ Culture ___ Recreation / Leisure ___ Health / Wellness ___ Other |
| |
|Target Population: Gender: Female _____ % Male _____ % |
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|Age Group: (Check all that apply) ___ 10 & under ___ 11 – 18 ___ 19 – 64 ___ 65 & older |
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|How many people will benefit from this initiative? |
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|Total cost: $ Amount requested from DRCF: $ |
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|Are funds from any other source confirmed? Yes No If yes, how much? $ |
| |
|How will the grant be used? (Check all that apply) |
| |
|___ Purchase of equipment ___ Travel ___ Marketing ___ Programming ___ Other |
| |
|Explain: |
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| |
| |
| |
| |
| |
|(Please feel free to include supporting documents describing/detailing the project and your organization) |
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|Start date of initiative: Date grant needed: |
| |
|Authorization (To be signed by two officers of organization’s Board of Directors verifying that the information provided above is correct) |
| |
| |
|x_____________________ _________________________ _____________________ _______________ |
|Signature Print Name Position Date |
| |
|x_____________________ _________________________ _____________________ _______________ |
|Signature Print Name Position Date |
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