Form YG4864 "Application for Child Care Enhancement Funding" - Yukon, Canada

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Download Form YG4864 "Application for Child Care Enhancement Funding" - Yukon, Canada

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application for child care
enhanceMent fUndinG
Name of Program ____________________________________________________________________________________________
Mailing address ______________________________________________________________________________________________
Community _____________________________________________________________ Postal code _________________________
Contact person __________________________________________________________ Phone number _______________________
Status
Registered non-profit society
Yukon First Nation
Private owner
If a non-profit society, do the constitution and by-laws contain a provision for the transfer of assets created by this program to
a related community agency, should your organization dissolve?
Yes. Please submit a copy of the provision.
No. The organization will be expected to adopt such a provision prior to any funds being processed. Indicate when such
a provision is expected to be included.
names of members of the board of directors or first nation council.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Describe the service you offer, including the number and age groups of children, hours of operation, program and staffing.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
What were your other sources of funding (not including parent fees, child care subsidies or direct operating grants) in the
past 12 months? include any grants and fundraising you may have received.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
YG(4864EQ)F2 Rev.08/2012
application for child care
enhanceMent fUndinG
Name of Program ____________________________________________________________________________________________
Mailing address ______________________________________________________________________________________________
Community _____________________________________________________________ Postal code _________________________
Contact person __________________________________________________________ Phone number _______________________
Status
Registered non-profit society
Yukon First Nation
Private owner
If a non-profit society, do the constitution and by-laws contain a provision for the transfer of assets created by this program to
a related community agency, should your organization dissolve?
Yes. Please submit a copy of the provision.
No. The organization will be expected to adopt such a provision prior to any funds being processed. Indicate when such
a provision is expected to be included.
names of members of the board of directors or first nation council.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Describe the service you offer, including the number and age groups of children, hours of operation, program and staffing.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
What were your other sources of funding (not including parent fees, child care subsidies or direct operating grants) in the
past 12 months? include any grants and fundraising you may have received.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
YG(4864EQ)F2 Rev.08/2012
list any request for equipment or renovations needed, with quotes from two suppliers for anything over $1,000.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
have you applied to any other organization for funding this project? please give details of any applications you have made.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Were you successful?
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
please outline how the funding you have applied for will enhance your program.
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
Do not hesitate to contact Child Care Services Unit for assistance in making this application. In Whitehorse,
call 667-3492 and in the communities, call toll-free, 1-800-661-0408, extension 3492.
Send this completed application to:
child care Services Unit, health and Social Services (h-12), Box 2703, Whitehorse, Yukon Y1a 2c6
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