2017 Community Sponsorship Application

HOW TO APPLY

1. Read “Community Sponsorships” to see if you are eligible (https://www.assiniboine.mb.ca/Community/SponsorshipsAndGrants/CommunitySponsorships)

2. Complete this form

3. Attach additional information and support materials if available

4. Send to: Sponsorship Coordinator, Assiniboine Credit Union, 200 Main Street, Winnipeg MB R3C 2G1 or email:

ABOUT YOUR ORGANIZATION

Name of organization

What is the mission (purpose) of your organization?

Does your organization work in the area of

Community Inclusion / Arts and Culture
Environmental Sustainability / Human Rights
Community Enterprise Development

ACU is particularly interested in supporting organizations that benefit marginalized communities. Please indicate if the primary purpose of your organization is to benefit: (check all that apply)

Aboriginal People
Newcomers
Disadvantaged Youth
People with disabilities
Women
Seniors
People living in Poverty
Other specific marginalized members of the community (please specify)

Charitable registration number (if applicable)

Annual operating budget

Name & position of contact person

Mailing Address

Street 1
Street 2
City / Prov / Postal Code
Phone / Email
Website

Is your organization a member of Assiniboine Credit Union?

Yes / No

If yes, what branch?

ABOUT YOUR REQUEST FOR A COMMUNITY SPONSORSHIP

Type of event (select one only):

Fundraising Event (ACU members only)
Arts/Cultural Event
Community Festival/Celebration/Awards
Total event budget: / Amount requested from ACU:

Other confirmed/potential sponsors

To whom should the cheque be made payable?

Name of event

Date of event

Location of event

Purpose of event

Briefly describe the event (attach additional materials if required)

How many people are you expecting?

Does the event benefit a specific geographic community? If so, please specify.

How will you evaluate the success of the event?

What recognition/profile or other benefits will ACU receive?

DECLARATION

Please confirm the following statements by placing a checkmark beside them:

I have read and understood the Community Sponsorships guidelines and eligibility criteria.
Our organization has not previously received a community sponsorship from ACU in 2017
I am authorized to make an application of behalf of this organization.
Within 60 days after the event, I agree to submit a short report outlining the success of the event and how ACU was recognized
Name & Position
Signature / Date

January 2017-CommunitySponsorshipApplication 3