Jack.org/Queen’s Student Initiative Fund(Jack.org/Queen’sSIF) Application Form
All fields are mandatory.
Group Name:Contact Name:
Phone Number:
E-mail address:
Provide a brief description of the project, activity or program – what is it?
(300 word maximum.)
How does the project align with the selection criteria? Think about what you are trying to accomplish. Please be as specific as possible. (300 word maximum.)
Planning timeline for project, activity or event? (Start date; End date.)
Exactly how much money are you requesting?
Has your group previously received funding from Jack.org/Queen’s SIF for a similar event? If yes, when was the event and how much funding did you receive?
How will the requested funds be used? (300 word maximum.)
Other possible sources of funding (to be received and/or being applied for)?
Estimated number of students and others who will benefit from the project?
In what way will Jack.org/Queen’sSIF be recognized as a sponsor of the event? This can be as simple as incorporating Jack.org logo (provided upon request) on posters or recognizing The Jack.org/Queen’sSIF through social media. (150 word maximum.)
If your group or event has a website, Facebook or Twitter page that you would like Jack.org/Queen’s SIFto recognize on its website and social media if the application is approved, please indicate below.
Does your group have any succession plans/mechanisms in place to ensure continuation of your activity/event once the current organizers have graduated from Queen’s?
If your application is approved, please indicate how you would like to receive the funds:
- A journal entry to transfer funds – this applies if your group has access to a chartfield recognized by Queen’s; if so, please provide the followinginternal account information:
Fund:
Department:
Account:
Program:
Class:
Project:
- A cheque issued in the name of the group - the cheque will be issued to the group and will have to be deposited into an authorized bank account in the same name.
- A cheque issued in the name of an individual - if so, please let us know who to make the cheque payable to and provide the individual’s Social Insurance Number. Please note that the amount may be considered income and therefore taxable. Individuals will receive a T4A from Financial Services.
Submit your Application Form and Budget Form to
Please note that successful applicants will be required to complete a Report Form and an updated Budget Form within 30 calendar days after the event/activity.Any unused portion of an award is to be returned. The Jack.org/Queen’s SIFAdjudication Panel is not responsible for covering deficits of events that cost more than the anticipated budget.
Thank you and good luck!
Updated: December 2015