REGION OF QUEENS MUNICIPALITY
GRANT APPLICATION
Name of Organization: ______
Mailing Address: ______
Contact Person: ______
Position in Organization: ______
Email address: ______
Telephone: (Bus.)______(Res.)______
Objectives and Purposes of Program:
______
______
______
______
Description: (include type of program, area served, number of people involved, location of program, duration of program, and volunteer involvement)
Type of Program: ______
Area Served: ______
Number of People Involvement: ______
Location of Program:______
GRANT APPLICATION
Program Duration: ______
Volunteer Involvement:______
Amount Requested: ______
Additional Comments in Support of Your Application:
______
______
______
______
Please ensure that you have attached a copy of a financial statement for your organization for the previous year and a budget for the upcoming fiscal period.
I certify that to the best of my knowledge, the information provided by me in this Grant Application form is accurate and complete and is endorsed by the organization that I represent.
Signature: ______
Name: (please print) ______
Date: ______
Phone Number: (Bus.)______(Res.)______
GRANT APPLICATION GUIDELINES
1. Each organization requesting funding will be required to submit a budget for the current fiscal period, as well as the previous year’s financial statement. The organization will be required to give an outline of the objective and purposes of their program.
2. Organizations will not be required, unless specifically requested, to make a presentation before the Committee of the Whole.
3. Grants will not be issued to organizations with a National or a
Provincial affiliation.
SUBMISSION DEADLINE IS May 3, 2013
Region of Queens Municipality
GRANTS TO ORGANIZATIONS
The Region of Queens Municipality is now accepting applications from Community Organizations for grants for the 2013/2014 fiscal year.
To qualify, organizations must be Queens County based, must submit a financial
statement for the previous year and a budget for the upcoming year. New organizations must submit a budget only.
Details and applications for funding are available from:
Address: Phone:
Heather Hurshman (902) 354-3453
Deputy Treasurer
Region of Queens Municipality
P.O. Box 1264
Liverpool, Nova Scotia
B0T 1K0
Application deadline is Friday, May 3, 2013
1