Rural Communities Foundation of Nova Scotia
Rural Innovation Fund
Grant Application
Deadline for Application: June 15, 2012, Noon
  • Refer to the guidelines before completing this application.
  • Submit one electronic copy of your proposal by email to, do not include additional attachments
  • To ensure your grant request is fairly evaluated, please provide the following information:

Organization Information:
Name of organization:
Charitable registration # RR0001 Year established:
Address:
Postal Code: Telephone: Fax:
Email: Web site:
Primary contact person: Title:
Telephone: Email:

This application must be signed by the Chairperson, President, Treasurer or Executive Member of the Board of Directors of your organization.

Please print signing authority (name and title)______

Please sign: NameTitleDate

Description of organization: A brief description including the mission statement, history of your organization, and other projects undertaken(one page maximum: 250-300 words).
Rural Communities Foundation of Nova Scotia (RCF)
Grant Request: Estimated project Expenses
Budget Items / Total Cost / Other Sources
Of Funds / Amount Requested
From RCF / Brief description of major budget items requested from RCF
Travel
Salaries and benefits
Honoraria and professional fees
Facilities
Office equipment
specific to the project
Materials and supplies
Publicity and promotion
Other (specify)
Total Expenses
Revenue Note: RCF grants do not require cost sharing dollars
Brief description of organization’s contribution (in-kind and/or financial)
Brief description of other principal funding sources for this project
Project objectives:
  1. Provide a brief description of your project.

  1. How long will your project last? (expected start and end dates)

  1. What need will your project fill? How was this need identified?

  1. Whywill your project be successful in meeting this need?In what way(s) is your project innovative? How is your approach a new way of addressing this need?

  1. Describe the outcomes you are expecting if your project is successful. What will be the tangible results/benefit for the communities? (describe the short and long-term impacts). How will these be measured?

  1. Who are your partners and how are they involved? What evidence is there of partnership development?

  1. What other public support is there for your project? What potential is there for collaboration within the community?

  1. Show how your project involves a wide cross section of the community.

  1. What is the project’s potential to build leadership and community capacity? What potential is there for future community development as a result of this project?

  1. What potential is there of addressing the economic, social and environmental priorities of the community?

Submission checklist Have you included the following?:
I have fully and accurately completed the organization information
I have confirmed our organization is a charity in good standing:
http//www/cra-arc.gc.ca/chrts-gvng/lstngs/menu-eng.html
I have provided a description of the organization, mission statement, other projects and a brief history.
I have provided an itemized project budget.
I have answered the 10 questions.
Ihave saved the application and will submit via email by the deadline.
I will fax, mail, or email the signature page to:
PO Box 1516
Truro, NS B2N 5V2
Fax: 902-897-4020 Email:
Conditions of acceptance:Your organization will provide a report at the completion of the project outlining how the money was used and include an evaluation of the success of the project.Your organization agrees to allow Rural Communities Foundation of Nova Scotia to respectfully share your granting story as part of our communications strategy.

Revised February 1, 2012

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