APPLICATION FORM FOR HHF FUNDING REQUESTS
ORGANIZATIONAL INFORMATION:
Name of Organization
*
Representative applying on behalf of the Organization
*
First Name
Last Name
Representative's Title
*
Add your position here
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
E-mail
*
Is this organization officially recognized as a Non-Profit or Charitable Organization in Canada?
*
YES
NO
Charitable Registration Number:
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Please provide a brief statement of your organization's mandate, history and accomplishments:
*
EVENT OR INITIATIVE SUMMARY:
Start Date:
*
mm-dd-yyyy
End Date:
*
mm-dd-yyyy
Amount of Funding you are requesting:
Describe the nature and importance of this project/initiative and how it aligns or advances the HHF's mandate:
*
What is it's purpose?
Describe the expected outcome and benefits of this project:
*
Who will benefit from this initiative?
Indicate whether prior HHF funding has been requested/given to your organization:
*
Has a funding request been previously submitted or approved to this organization?
Location:
*
Where is it taking place?
Size and Scope:
*
How many are expected to attend, participate and/or benefit from this project?
Primary Audience:
*
Who will benefit from such an initiative?
Include list of Board of Directors and or Volunteer Committee Members:
Include information above.
Include list of other committed or approached donors/sponsors:
Include information above.
Include project budget showing anticipated expenses and income:
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of
Include most recent financial statement (for funding requests over $5,000):
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of
Include Sponsorship Package or Form (if applicable):
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of
Add other relevant information here:
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of
Submit
Should be Empty: