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2024 Grant Application

Name of Organization

Contact Information (first name)

Contact Information (last name)

Telephone Number

Email Address

Street Address

Town

Postal Code

Grant Request (not to exceed $ 15,000)

Description of Organization/Initiative

Describe how your organization's application meets the eligibility criteria as outlined in F-11 - Municipal Grants Program Policy?

Based on your organization's financials, is your organization/initiative dependent on the request for the Municipal grant. If you are not successful with the grant application, what is the next plan for funding?

Is your organization requesting funding from other regional or municipal, federal or provincial government(s)?

Yes

Evidence of Need

1) What specifically is the grant being used for and how will the grant support the goals of your organization?

2) How will the initiative support and provide direct and/or indirect benefit(s) to Leamington residents?

Outcomes

3) What is the desired outcome of the initiative and this grant application?

4) How will your organization determine if these desired outcomes are achieved?

Access to the Initiative

5) Who will benefit from this initiative? How will the intended beneficiaries have access to the initiative?

6) Will your initiative involve volunteers? If so, how many? How will the initiative involve volunteers?

Cost of the Initiative

7) Please provide the budget for the initiative. Provide the detailed revenues and expenses that are proposed for the initiative?

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8) If your organization is not able to achieve the budget, how will the deficit be funded?

9) What are your organization's plans for sustaining or exiting the initiative once it is complete?

Is there any other information you would like to include that is relevant to your application? Any relevant information provided can be used to adjust scores awarded in any of the sections above.

By checking this box, you are indicating all information entered within this document is correct, and all future correspondence is to be conducted with the email address indicated on this form.

Yes all information is correct.

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2024 Grant Application

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