Required fields are marked with asterisks (*)

Community Grant Application

NOTE: The following are to be included with this application:

1. A statement of the organization's/association's goals and objectives, programs or services, constitution and by-laws or, if a new group, operating guidelines.

2. Copy of the most recent (audited) Financial Statements (if available).

3. Statement of Estimated Revenues and Expenditures.

4. Details of how much fundraising revenue was donated in the prior year (if annual event).

Alternate formats are available upon request by contacting 905-985-7346 or accessibility@scugog.ca.

A. Organization/Association Information

Organization, Individual or Team:

Telephone Number

Street Address

Postal Code

Province

Contact Name

Position

Telephone Number

Cell Number

E-mail

B. Event/Program/Services Information

Description of Event, Program, and/or Services

Date(s) of the Event:

Time(s):

Geographical Area Served by your Organization:

I have read the Community Grant Policy and I confirm my event meets the requirements

I confirm

C. Financial Information

Amount of Financial Assistance Requested:

$500 - One-day Event

$1000 - Multi-day Event

Receipts or financial papers (if applicable):

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

D. Certification

We certify that, to the best of our knowledge, the information provided in this Application for a Community Grant is accurate and complete, and endorsed by the organization which we represent.

Name

Position with Organization/Association

Date

Name

Position with Organization/Association

Date