APPLICATION FOR ASSISTANCE
GRANTS & CONTRIBUTIONS PROGRAMS
APPLICATION FORM FOR: Inuit Societal Values ONLY
Department of Culture and Heritage.
Government of Nunavut
GOV. Logo
Instructions:
Application deadline for the first call: March 31
Please print or type when completing this form
Attach a separate sheet to this application if you need more space
Submit application to:
Shuvinai Mike
Director, Inuit Qaujimajatuqangit
Department of of Culture and Heritage
P.O Box 1000, Stn 800, Iqaluit NU X0A-0H0
Applications submitted to any address other than the oneslistedbelow will not be considered
Please Provide which program you are applying under:
Achieving and maintaining healthy communities (Inuuqatigiitsiarniq) and Self- reliance (Namminiq Makitajunnarniq) is a priority of the Government of Nunavut using approaches that reflect Inuit Societal Values.
The role of Elders was diminished when large communities were established. Through the Inuit societal Values pilot project, the goal is to strengthen elders’ roles in the process of addressing social and community well-being issues.
Preferred Communication/s Language:  Inuktitut  Inuinnaqtun  English  French

Note:

  • Only one proposal per application.
  • Funding received in one year does not guarantee funding in subsequent years
  • Funding must be spent within the fiscal year for which it was awarded.
  • Successful applicants applying as individuals are responsible for declaring total amount approved as income for income tax purposes.

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Section A (Organization ONLY)

Name of Organization:
Mailing Address
Community / Postal Code
Phone Number
Fax Number
Email
If your organization is registered as a non profit organization, please include Certificate of Registration and provide the following:
Registration Number:

Organization Contact:

First Name
Last Name

Alternate Contact: (For both individual and Organization)

First Name
Last Name
Position
Phone Number
Fax Number
Email

Note:If your organization is registered as a non-profit organization, registration papers must be included with this application.

If your group is not registered, please provide the name of the member in whose name the contribution agreement and cheque are to be made out to.”

Name of the Proposal:

Project Proposal & Project Schedule:

Please describe the intent of your project, how you plan on carrying out your project, and your expected outcome. Be sure to include how your project will benefit Nunavut through either the promotion, preservation of Inuit / Inuinnaqtun / French Language. Attach a separate sheet if you need more space. Also state your expected start and finish dates.

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Additional Information

Provide any additional information that you think will add to your application

Assistance from Other Sources

List financial of other assistance secured with any sources other than the Department of Culture and Heritage
Name of Source / Contact Name / Telephone / Dollar Value
Total (1)
List financial of other assistance that you have requested from sources other than the Department ofCulture and Heritage
Name of Source / Contact Name / Telephone / Dollar Value
Total (2)
Total all other sources Total (1) plus total (2)

Previous Support:

Please list any previous financial support you have received from the Department of Culture and Heritage

Project Budget

Provide a detailed budget breakdown indicating costs by category for the proposal.
Item Description: / Amount requesting from CLEY:
Subtotal
(less) total assistance from other sources (pages5)
Total Requesting:

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References

You must enclose at least two letters of support with your application. Please list below the names of the persons providing the letters of support.
Name: / Telephone

Applicant’s Statements

I hereby certify that the information contained in this application is true and correct to the best of my knowledge and belief, and that I do not have any outstanding commitments resulting from any previous projects funded by the Department of Culture and Heritageof the Government of Nunavut.

Signature / Date (YY/MM/DD)
Witness / Date (YY/MM/DD)

Prior to submitting the application form:

Please ensure the application is fully completed.

Please attach any documentation supporting the proposal.

Please ensure that if your organization is registered as a

non-profit organization, registration papers must be included with this application.

 Please ensure the organization is in good standing with the Legal Registries.

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