GRANT APPLICATION FORM
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1 GRANT APPLICATION FORM intended for the First Nations social economy enterprises Description of the grant First Nations Gathering on the Social Economy (FNGSE) February 8 and 9, 2017 Hotel Plaza, Québec City In the context of the first edition of the First Nations Gathering on the Social Economy (FNGSE), the FNQLHSSC is pleased to offer participation grants that are intended for the social economy enterprises of the First Nations of Quebec. Thanks to these grants, representatives of the First Nations social economy enterprises across Quebec and from various activity sectors will be able to participate in this unique and inspiring event on the social economy. The participation grant will cover all of the costs associated with accommodations and transportation in order to participate in the FNGSE that will be held on February 8 and 9, The FNQLHSSC will reimburse the following expenses for one representative per enterprise that receives the grant: accommodations, meals, transportation (the most cost-effective means), incidentals and parking according to the FNQLHSSC s financial policy. Representatives must keep and submit the original copies of the hotel invoices and the train or plane tickets as well as the boarding passes in order to be reimbursed. A reimbursement claim form will be provided to the representative on site. Eligibility criteria The eligible First Nations social economy enterprises are as follows (according to the Social Economy Act [RLRQ, chap. E-1.1.1]): The First Nations or Inuit* non-profit (NP) organizations in Quebec The First Nations or Inuit cooperatives (COOP) in Quebec * An enterprise is considered an Aboriginal enterprise when it is at least 51% owned and controlled by First Nations or Inuit. The social economy enterprise (NP or COOP) must demonstrate that: It meets a need of the community or its members Its activities are focused on collective well-being and the improvement of the socioeconomic conditions It generates independent income resulting from commercial activities It operates based on a democratic governance model that is independent from the State Instructions pour remplir la demande : Électroniquement : Go to the following web page: Click on the Call for grants for the First Nations social economy enterprises tab Important: fill out the grant application form and save it once it is completed Send it to the following address: reception@cssspnql.com, while indicating in the subject line: GRANT APPLICATION FOR FIRST NATIONS SOCIAL ECONOMY ENTERPRISES By hand : Print out the form and fill it out legibly; Send the form by fax at while specifying on the cover sheet: GRANT APPLICATION FOR FIRST NATIONS SOCIAL ECONOMY ENTERPRISES, to the attention of Karine Awashish, Social Economy Advisor. PLEASE RETURN THE COMPLETED FORM, BEFORE DECEMBER 1, 2016, TO THE ATTENTION OF KARINE AWASHISH, SOCIAL ECONOMY ADVISOR
2 GRANT APPLICATION FORM intended for the First Nations social economy enterprises First Nations Gathering on the Social Economy (FNGSE) February 8 and 9, 2017 Hotel Plaza, Québec City Name of the organization or enterprise ENTERPRISE IDENTIFICATION FORM Address Postal code: Representative s name Job Title Telephone: Website: MAIN ACTIVITY SECTOR (PLEASE SELECT THE MAIN SECTOR OR SECTORS OF YOUR ORGANIZATION/ENTERPRISE) Community-based Health and social services Early childhood Natural resources Media/communications Environment/sustainable development Retail business Services to people Representation and consultation Arts and culture Financing Agri-food Construction Recreation/tourism Collective property Transportation Business services Research Others : please specify 1 DESCRIPTION OF THE ORGANIZATION (MANDATORY) 1.1 State your organization s mission. 1
3 1.2 Provide a summary description of your organization s range of products or services. 1.3 Who are the main clients for your products or services? 1.4 Does your enterprise respect the principles of the Social Economy Act as described below? Please check all situations that apply to your organization. The organization/enterprise aims to meet the needs of its members or community (social mission). The organization/enterprise is not under the decisional control of one or more public or political organizations. At least 50% of its board of directors is therefore composed of representatives from different levels of government (band council, municipal council, provincial government or federal government). The rules that apply to the organization/enterprise provide for democratic governance by its members, namely through the holding of an annual general assembly. The organization/enterprise aspires to economic viability meaning that it plans its activities in such a way as to generate independent income from commercial activities. The organization/enterprise anticipates that if it makes a profit, once it has paid the balance of its expenditures, it will invest the profit in the organization or in the community. 2 DEMONSTRATION OF YOUR INTEREST TO PARTICIPATE IN THE FNGSE (MANDATORY) 2.1 What is the main motivation of your organization/enterprise to participate in the FNGSE (maximum of 150 words)? 2
4 2.2 What are the topics in which you would be most interested? Please select one or more themes: Definition and characteristics of the SE Funding and investment tools Management tools and methods Knowledge development in the SE sectors Training tools Discussions and sharing SE networking Others : please specify 2.3 What actions or measures will you undertake in order to share the information and/or experience acquired at the FNGSE for your community or organization? ( maximum of 150 words ) 2.4 Do you have any other information or comments to share with us? ( maximum of 150 words ) 3 HISTORY OF THE ENTERPRISE (OPTIONAL) 3.1 Explain how the creation of your organization/enterprise came about. For example: The date it was created; interest associated with undertaking the socioeconomic project; to what issue or issues did your project respond; how did the mobilization take place; etc. ( maximum of 150 words ) 3
5 3.2 Briefly summarize the successful initiatives of your organization/enterprise. For example: Describe the activities that have attracted increased participation and/or a positive response from the community or target clientele. ( maximum of 150 words ) 3.3 Do you have any other information or comments to share with us? (maximum of 150 words) 4
6 DO NOT FORGET TO SEND US YOUR GRANT APPLICATION FORM BEFORE DECEMBER 1, 2016 For more information, please visit the website of the First Nations Gathering on the Social Economy at
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