Application Form (Schedule A)

Introduction

Land Stewardship Centre (LSC) thanks you for your interest in the Watershed Stewardship Grant (WSG) Program. Before completing this application form please read the Watershed Stewardship Grant Application Process document. In completing this application form you must demonstrate that your group meets the eligibility requirements outlined in that document. Make sure you complete the entire application form, providing all information as requested. Ensure the completed application form is dated and signed.Incomplete or unsigned applications will not be considered.

If you have any questions regarding the application, contact the Stewardship Program Coordinator at or 1-877-727-5276. Please note you should also keep a copy of your application for reference.

Send your completed application to Land Stewardship Centre on or before the application deadline.

By Mail:Land Stewardship Centre
17503 – 45 Avenue
Edmonton, Alberta T6M 2N3
Attention: Watershed Stewardship Grant Program

By Fax:(780) 486-9599

By E-mail:

NOTE:Receipt of applications submitted by regular mail cannot be guaranteed. If you choose to send your application through the Postal Service, it is highly recommended you send it by registered mail.

Application Deadline

Complete, signed applications must be received at the LSC office on or before16:30 MST, March 1.

Distribution of Grant Funding to Successful Applicants

Funding awarded to successful stewardship groups will be distributed in two phases:

  1. 75% of the total approved grant funding will be provided to successful recipients upon signing of the WSG Agreement.
  2. The balance of approved grant funding (25%) will be provided to recipients upon submission of completed interim report. The deadline for submission of the interim report is September 30. Note:Grant recipients may receive the balance of approved grant funding (25%) prior to September 30 as long as their interim report has been submitted.

Project Completion

All projects must be completed on or before April 30 in the year after grant funds were received. For example: if grant funds received May 2014, project must be completed byApril 30, 2015.

For Official Use Only

Date Received:
Application Number:
Acknowledged:YesNo
Group Reference Number:

A. Your Organization

The group/organization named in this application is applying as a (select one):

Unincorporated group – applicantis not a legal entity and is applying in partnership with a legal entity (provide legal name of partner organization here):

Incorporated group – applicant is a legal entity (i.e. registered society or non-profit organization)

If incorporated, please provide your group’s society or non-profit registration number:

If your group is also a registered charity, please provide your charitable registration number:

If your group has a GST registration number, please provide it here:

Group/Organization Name

Mailing Address

(NOTE: All correspondence regarding the WSG program and this application will be sent to this mailing address)

Address
City/Town
Province
Postal Code
Phone
Email

NOTE:You must provide at least two different contacts for your group/organization.

Primary Project Contact

Name (first and last)
Title
Phone
Email

Secondary Project Contact

Name (first and last)
Title
Phone
Email

Additional Project Contact

Name (first and last)
Title
Phone
Email

Signing Officer of Incorporated Group or Partnering Legal Entity[1]

(NOTE:You must complete this even if it is a repeat of one of the contacts above)

Name (first and last)
Title
Phone
Email

B.Group/Organization Profile

  1. Briefly describe your group’s vision, mission, goals and objectives.
  2. Please include when your group was formed/how long your group has been operating, number of members you haveand major partnerships you have established
  1. For groups without legal status, which are applying in partnership with another legal entity, briefly describe the organization you are partnering with.

C. About Your Project

Project Title and Location

Project Title

Project Location(County or MD)

Nearest City/Town/Village

Watershed

Legal Land Description

GPS Co-ordinates(optional)

Google Map Link(optional)

Project Description

  1. Describe your project and how it aligns with the overall initiative or mandate of your group.
  2. Identify all partner groups and organizations that will be involved in the development and delivery of this project, and indicate how each will contribute to the project.
  3. Describe how volunteers and your local community will be involved in the project.
  4. Explain what watershed situation, question, issue or challenge this project will address (i.e. why is your group pursuing this project).
  5. List who have you consulted with to develop this grant proposal(i.e. other agencies, organizations, resources and information sources used).

Project Focus

Which of the following five themeswill your project activities be focused on? Your project must address at least one of these themes(check all that apply):

Increasing awareness and knowledge – These activities directly increase the awareness and understanding of local watershed issues. Examples include: workshops, conferences, fieldtrips or demonstrations, interpretive/informational signage, information resources (i.e. brochures, fact sheets, etc.), media relations, website development, recognition and celebration programs.

Tool building – These activities involve the development of tools that demonstrate, test, support or convey watershed management options and practices. Examples include: how-to guides, beneficial management practices, demonstration sites, models or displays, as well as the development of state of the watershed reports, community watershed management plans or drinking water source protection plans. Please note: Applicants undertaking a State of the Watershed Report, watershed management plan or drinking water source protection plan are strongly encouraged to contact and engage their Watershed Planning and Advisory Council (WPAC) in plan development.

Team building – These are activities that build membership and organizational capacity. Examples include: facilitation and logistical support for strategic planning, educational events or workshops, and technical training.

Biophysical and social monitoring – This includes activities that measure environmental and social indicators of watershed health. Examples include: community water quality monitoring programs, riparian health inventories and/or assessments, upland range health surveys, wetland inventories, biodiversity inventories and/or assessments, surveys and community-based monitoring projects. Please note: Applicants requesting funds for monitoring programs should explain how monitoring will benefit partners in the initiative, how data will be managed and how results will be incorporated into future decision-making.

Community-based action – This includes physical, on-the-ground activities that directly improve the condition of a local watershed. Examples include: riparian plantings, bio-engineering activities, fish habitat enhancement, lake and/or shoreline clean-ups, invasive species removal, sediment management, wetland restoration and upland vegetation establishment projects.

Project Objectives

Outline up to three objectives for your project and describe how these will be achieved. Keep in mind project objectives are different from the categories of activities you selected above.

Objective 1:
Achieved by:

Objective 2:
Achieved by:

Objective 3:
Achieved by:

Watershed Planning and Advisory Councils (WPACs)

WPACs are important stewards of Alberta's major watersheds. They are independent, non-profit organizations that are designated by Alberta Environment to assess the condition of their watershed and prepare plans to address watershed issues. They also conduct education and stewardship activities throughout their watershed. Within Alberta there are currently eleven WPACs.

  1. Please identify which is the active WPAC in your region (select one only):

Athabasca Watershed Council
Battle River Watershed Alliance
Beaver River Watershed Alliance
Bow River Basin Council
Lesser Slave Watershed Council
Mighty Peace Watershed Alliance
Milk River Watershed Council Canada
North Saskatchewan Watershed Alliance
Oldman Watershed Council
Red Deer River Watershed Alliance
South East Alberta Watershed Alliance

  1. Have you discussed your project and/or WSG grant application with your WPAC?

Yes. If yes, please describe how your WPAC may provide support to your project.

No. If no, why not?

D. Project Outcomes and Evaluation

  1. The three goals of the Water for Life strategy are:
  2. Safe, secure drinking water supply,
  3. Healthy aquatic ecosystems, and
  4. Reliable, quality water supplies for a sustainable economy.

How will your project contribute to one or more of these goals on a local and/or larger watershed scale?

  1. How will you evaluate the success and achievements of your project?(Quantitatively i.e. number of new volunteers engaged, participants at events, workshops conducted, trees planted, riparian assessments conducted, etc. and qualitatively i.e. improved water quality, enhanced riparian condition, less garbage in natural areas, decrease in invasive plants, etc.)
  2. Please describe how your project addresses or impacts at least one of these themes:

Theme / How does your project address or impact this theme?
Awareness and knowledge of local watershed issues within the community.
Adoption of practices and actions that benefit the watershed.
Environmental conditions improve and/or change within the watershed.
Your group’s ability to continue its work and take on new activities to achieve your goals and objectives.
  1. Do you intend to continue this project when the WSG funding runs out?

Yes. If yes, please describe how you will keep this project going.

No. If no, why not?

E. Project Activities and Timelines

Please outline the specific activities you will carry out to complete your project, when you plan to complete these activities, and what final result or product will be associated with each activity.
Please note: Completion and submission of interim and final reports are requirementsunder the WSG grant agreement and as such have already been included in this list.

Project Activity / Expected Completion Date / Expected Outcome or Product
Prepare and submit interim WSG report / October30 / Interim report completed and submitted to Stewardship Program Coordinator by October30
Prepare and submit final WSG report / April 30 / Final report (including all receipts for expenses) completed and submitted to Stewardship Program Coordinator by April 30

F. Project Budget

Please read the Important Notes – Project Budget section before completing the followingIncome and Expenses tables.

Important Notes – Project Budget

Eligible Expenses – Notes and Limitations

Materials and supplies (i.e. office supplies, food for events, machinery and equipment rentals, hall rentals), salaries and wages, contract services, travel, honorariums, and certain capital expenses (i.e. necessary furniture, equipment and other assets with a value greater than $200) are considered eligible project expenses.

To be considered eligible for reimbursement, all expenses (with the exception of mileage and travel meals – see below) MUST be accompanied by receipts.

PLEASE NOTE: GST is NOT an eligible expense and will not be covered by WSG funds.

  1. To be eligible, any travel expenses claimed (i.e. mileage, airfare, travel meals, etc.) must be directly associated with project implementation and delivery. A maximum of 25% of the total WSG grant funds received can be used to cover project travel expenses. Eligible mileage and travel meals must be appropriately documented and will be reimbursed at current Government of Alberta rates.
  2. Mileage $0.50 per kilometer
  3. Breakfast $9.20
  4. Lunch $11.60
  5. Dinner $20.75

To be considered for reimbursement, all other travel expenses (i.e. accommodations, airfare, etc.) must be accompanied by receipts.

  1. Capital expenses are generally ineligible except where they can be proven to be essential to the success of the project. In this case, use of the item by the group during and once the project is completed should be submitted as part of final reporting on the project. Eligible capital expenses may include items such as off-site watering systems, bridges on trails, laptops, data projectors, scientific equipment or other technical devices. Up to 100% of the total WSG funding received can be used to cover the cost of eligible capital purchases.
  2. Up to 75% of the total WSG funds received can be used to cover the cost of salaries and wages for project coordination and administration.
  3. Up to 100% of the total WSG funds received can be used to cover the cost of eligible contract services. Contract services are any services (technical, equipment or professional services) provided by an independent contractor and may include diagnostic services, catering, website development, meeting and planning facilitation, etc. This does NOT include services provided by an individual hired as a Project Coordinator or Administrator.

In-Kind Contributions

In-kind contributions are services or items which ordinarily would be paid for by your organization but which are being voluntarily contributed to help carry out your activities. These can include use of equipment, supplies, materials, the donation of facilities or rent, as well as volunteer services provided by individuals.

The test for in-kind contributions is this: if the service or item was not being donated at no-charge, would your organization pay for that service or item? If the answer is yes, then it is a valid in-kind contribution that you may claim.

Estimates for the value of in-kind services should be calculated using the following rates:

  1. Volunteer time – $20 per hour
  2. Technical services (i.e. lab or field technician) – $30 per hour
  3. Equipment services (i.e. tractor and operator) – $40 per hour
  4. Professional services (i.e. biologist, caterers) – $50 per hour

Estimates for the value of in-kind or donated items (i.e. materials and supplies, capital assets, food, hall or equipment rentals, etc.) should be requested from the person or organization supplying the item to the project and should reflect the current market value of the item being donated

Income

Please identify all sources of income (cash and in-kind) for your project including the amount of WSG funds being requested in this grant application and indicate if funding from that source has been confirmed or not.

Funding/Income Source / Amount – Cash / Amount – In-Kind / Total / Funding Confirmed?
Watershed Stewardship Grant / N/A / Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Total Income
(cash and in-kind)

Expenses

Identify all estimated expenses for your project in the table below.

PLEASE NOTE:While your group may have to pay GST on products and services, and as such it may be an expense to your group, GST is NOT eligible to be covered by/paid for with WSG funds. GST must be paid for from funds other than the Watershed Stewardship Grant.

Item or Service / Total Cost / Portion of Total Paid from WSG Funds* / Portion of Total Paid from Other Sources: Cash / Portion of Total Paid from Other Sources: In-Kind or Donation
Total Estimated Expenses

G. Additional Information

  1. If you wish to provide any additional comments in support of your application, please enter them here:
  2. Include any relevant supporting documents (i.e. photographs, maps, drawings, letters of support, etc.)you feel will add value to your application. Please limit these to no more than two additional pages of attachments.

H. Funder Recognition

Explain how you plan to acknowledgethe funders and sponsors (cash and in-kind) of your project, including LSC and the Watershed Stewardship Grant Program.

I. Previous WSG Funding Recipients

NOTE: Complete this section ONLY if your group has received WSG funding in the past.

Year Funding Received / Project Name / Amount of Funding Received
  1. If you receive funds under this grant application, please describe how these new funds will contribute to projects previously funded by a Watershed Stewardship Grant.
  1. If your proposed project is similar to or the same as previous projects, how will this new project grow, evolve or advance your group’s stewardship efforts?

J. Declaration

I, on behalf of (insert group/organization name here) , declare that:

  1. All information provided in this application is complete and accurate to the best of our knowledge.
  2. My group/organization's financial procedures include adequate safeguards against fraudulent or corrupt actions.
  3. No changes will be made to any of the project details without first notifying the Stewardship Program Coordinator.
  4. Our group/organization will comply with the criteria for appropriate acknowledgement of Land Stewardship Centre and Water for Life for receipt of WSG funding.
  5. We have read and understood the eligibility requirementsoutlined in Watershed Stewardship Grant Application Process document and have based our application on the guidance notes contained within it.

Date:

Name:(first and last)

Signature:

Watershed Stewardship Grant Program – Application Form (Schedule A) | Revised2014 | 1

[1] This is the person responsible for signing grant agreements on behalf of the applicant as outlined in the WSG Grant Application Process.