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Community Resource Centre Intake Form
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Vitality Grant Proposal
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Vitality Grant Proposal
This proposal form will take an average of 1 hour to complete. Please read through all of the question/submission fields before you begin to ensure that you have all materials at the ready. Do not close this web browser if you need to pause your application and return to it later.
PROPOSAL - SCHEDULE A
Name of Applicant(s):
First Name Last Name, separate each applicant name with a comma
Name of Project Lead:
First Name Last Name
Primary contact number
Total Requested Grant Amount for Proposed Project:
Applicant Type (please check one):
Duration of Project:
From: DD/MM/YYYY To: DD/MM/YYYY
Location of Project (if different from mailing address of applicant):
SECTION 2. PROJECT DESCRIPTION
1. Statement of Need: What community issues, need or situation is your project focused on? Please include any supporting information or resources.
2. Overall Goal: What change or impact do you want to achieve?
3. Broad Strategy: How will your project address the identified issue, need or situation? Please list project milestones.
4. Who will benefit from this project in the community?
5. How will the project be carried out with consideration to general safety, and safety precautions for COVID-19?
SECTION 3. EXPECTED RESULTS/OUTCOMES
1. What would be the most significant change your project would have on the community?
SECTION 4. PARTNERSHIPS AND SUPPORTS
1. Are there any partners and stakeholders involved? Briefly describe the role they will play.
2. Please list any other funding planned for this project, secured or unsecured including in kind contributions.
3. If this application was partially approved or not approved for any funding, is the project lead prepared to proceed with the project/event? If yes, to what extent?
Upload Schedule B - 2021 Community Vitality Grant Project Expense Report
Click the 'Browse' button and select the relevant files for upload from your device. We accept .PDF .JPG and .PNG
By submitting this proposal, I/We agree to comply with the requirements stated in this proposal.
DECLARATION The project lead declares that it has complied in every respect with all the instructions, and that it has satisfied itself fully relative to all matters and conditions with respect to the general conditions of the agreement and all relevant information to which this application pertains.
This field will serve as your final digital signature, indicating that all of the above fields and submitted items have been completed accurately to the best of your knowledge.
The personal information on this form is collected under the authority of Section 33(c) the Freedom of Information and Protection of Privacy Act, for the purpose of ensuring that an individual is eligible for the Vitality Grant program and will be protected under the provisions of the Act. Personal information, will not be published unless expressed consent is provided. Email addresses will be utilized to facilitate contact if no other means are available.
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