CITY OF POWELL RIVER GRANT-IN AID APPLICATION Purpose To provide not-for-profit organizations support in performing a specific program, project, or event. Grants are considered on an annual basis and continuing assistance should not be anticipated. Eligibility Applicants must demonstrate: Evidence of community need Potential benefit to the residents of Powell River Partnerships within the community and support from other sources Ability to deliver the proposed program, project, or event Public access Evidence of financial need Grants will not be awarded to/for: Individuals For-profit organizations Charitable organizations, unless the services are delivered directly to the residents of the Powell River Commercial activities Prior year losses, or debt repayments Private or invitation only events Prizes or awards Activities that are the mandate of other levels of government Travel and competition costs Please review Council Policy 261, Appendix A, Category 3 for a full description of the eligibility criteria. Does your organization meet the criteria? Yes No If yes, please complete this application. Feel free to use additional sheets of paper if necessary. Submit your completed application by email or regular post by March 31 st to: Attention: Financial Services Department City of Powell River 6910 Duncan St Powell River, BC V8A 1V4 financecontact@powellriver.ca 1
CITY OF POWELL RIVER GRANT-IN AID APPLICATION Background Information Name of organization: Mailing address: Postal code: Phone number: Contact person: Fax number: Contact person s phone number: Email address: Executive positions in the organization: Name Title President Vice President Secretary Treasurer Have you received a grant in previous years? Yes No If yes, when and previous grant amount $ If yes, have you submitted a final report? Yes No Is your organization registered as a not-for-profit society in BC? Yes No Incorporation number and date of incorporation (if applicable): Charitable registration number (if applicable): 2
In-kind grant amount requested: $ For in-kind grants, please attach support for the amount requested (e.g., a facility rental agreement quote from the Booking Clerk at the Recreation Complex). Cash grant amount requested: $ List the status of other funding sources applied for (if applicable): Describe your organization, its mandate and programs: Provide a brief description of the project and why you believe it should receive City funding: 3
Provide the date and location of the project: Describe the general benefit to Powell River: Please complete this additional section if there is an economic benefit to the community. Expected number of visitors to Powell River: Average duration of stay in Powell River for visitors: Description of marketing or activities used to attract visitors: Please contact the Director of Parks, Recreation and Culture at 604-485-8907, regarding other assistance and information that the City can provide to your group or organization. 4
Project or Event Budget Proposal Revenue and Expenses Please give details of revenue and expense projections. REVENUE (Please state source) EXPENSES (Please itemize) Description Amount Description Amount SECURED FUNDS SECURED FUNDS SUBTOTAL ANTICIPATED FUNDS ANTICIPATED FUNDS SUBTOTAL TOTAL FUNDING TOTAL EXPENDITURES Definitions: Secured funds: money that is currently available for the project. Anticipated funds: sales, grants and donations that is expected to provide money for the project. Please describe grants as cash or in-kind. Expenses: include service provider quotes, if applicable. 5
Application Checklist: Complete application in full. Enclose a copy of most recent year-end financial statements, including a balance sheet and income statement. For in-kind grants, please enclose support for the amount requested (e.g., facility rental agreement quote from Recreation Complex). For the quote, please contact the Booking Clerk at 604-485-8909. Include any additional material which would assist the City in assessing your project, such as photographs, price quotes, letters of support, proof of donation, and applications for other funding sources for the same project. Submit your completed application by email or regular post to: Attention: Financial Services Department City of Powell River 6910 Duncan St Powell River, BC V8A 1V4 financecontact@powellriver.ca Applications must be received before the deadline of March 31 st in the current year. NOTE: INCOMPLETE APPLICATIONS WILL NOT BE FORWARDED FOR CONSIDERATION I have read the City of Powell River s Council Policy 261, and Appendix A Investment through Grants Grants Application and Process Guideline and certify the information contained in this application is true and accurate to the best of my knowledge. I understand additional information may be requested prior to consideration of a grant-in-aid. I understand it is the responsibility of our organization to meet the responsibilities of section 3.3 of Council Policy 261 Appendix A. Submitted by (please print name): Signature: Date: Knowingly submitting an application or information that is not true or accurate will result in loss of eligibility. 6