"Commemorations & Celebrations Program Application" - New Brunswick, Canada

ADVERTISEMENT
ADVERTISEMENT

Download "Commemorations & Celebrations Program Application" - New Brunswick, Canada

278 times
Rate (4.5 / 5) 19 votes
D
T
, H
C
EPARTMENT OF
OURISM
ERITAGE AND
ULTURE
C
& C
P
OMMEMORATIONS
ELEBRATIONS
ROGRAM
Please read the Program Guidelines before completing the application.
It is highly recommended that first-time applicants contact Heritage Branch to discuss eligibility
and the application requirements. thctpcinfo@gnb.ca (506)453-2324
Section 1 – Applicant Information
Municipality or Legal Registered Name of Organization
Non-profit Status and Date of Incorporation
Organization’s Mailing Address
Contact Person / Salutation / Title
Email
Phone
Web Site Address
D
T
, H
C
EPARTMENT OF
OURISM
ERITAGE AND
ULTURE
C
& C
P
OMMEMORATIONS
ELEBRATIONS
ROGRAM
Please read the Program Guidelines before completing the application.
It is highly recommended that first-time applicants contact Heritage Branch to discuss eligibility
and the application requirements. thctpcinfo@gnb.ca (506)453-2324
Section 1 – Applicant Information
Municipality or Legal Registered Name of Organization
Non-profit Status and Date of Incorporation
Organization’s Mailing Address
Contact Person / Salutation / Title
Email
Phone
Web Site Address
Section 2 – Project Proposal
Project Title:
Location of Project:
Target Audience:
Anticipated Number of People Reached:
Commencement Date:
Completion Date:
Please read the program guidelines to see if you are eligible for funding before
applying.
Please use the headings below when formulating your proposal.
1. In a few sentences, briefly describe the initiative.
2. Indicate how the proposed project will commemorate or celebrate the history of New
Brunswick.
3. Provide a timeline showing the major milestones of the initiative.
4. Describe the long-term impacts of your initiative on your organization and your
community.
5. Describe how you will measure the success of the project. Please describe what you
will measure and how you will measure it.
Section 3 – Project Budget
Provide a budget for this initiative including all revenues and expenses and any in-kind
contributions.
Please list all other Federal or Provincial funding programs that have been applied to for this
initiative.
Budget must be balanced to be considered for funding.
P
R
ROJECTED
EVENUES
P
LEASE ADD LINES IF REQUIRED
Federal government (specify)
Grant Requested
Other Provincial government (specify)
Please add lines to specify other GNB financial assistance.
Municipal government (specify)
Other funders (specify)
Financial contribution of applicant organization
Partners’ contribution
Private sector contribution
In-kind donations (specify approx. value). Please note that in-kind values donated must be
reflected in the appropriate categories of expense. Please indicate the origin of the in-kind
donation.
Rental of premises or venue
Donation of material
Professional/volunteer time
Other (specify)
Total Revenues (Must equal total expenditures)
$
P
E
ROJECTED
XPENDITURES
Equipment
Materials
Technical and production fees
Coordination
Professional fees
Venue rental
Production costs (if not included above)
Advertising, brochures, and promotion
Other costs (specify):
Total expenditures (Must equal revenues)
$
Section 4 – Declaration
I affirm that the information in this application is accurate and complete and that the project proposal,
including plans and budgets, is fairly presented.
I certify that my organization is incorporated in New Brunswick, that I have signing authority for the
above-named organization, and that the Board of Directors has reviewed and approved this application.
I agree that, upon approval, I commit to completing this initiative precisely as described in this
application.
I agree that once funding is provided, any change to the project proposal will require prior approval from
Heritage Branch.
I agree to acknowledge the financial participation of the Province of New Brunswick in all publicity
related to the activities of the proposed project.
I agree to submit a final report and financial accounting for evaluation of the initiative within 30 days
following the end of the initiative.
I hereby acknowledge and agree that, if awarded a grant, the name of the grant recipient, the
recipient’s community, the program name, and the amount of the grant, will be published by the
Department of Tourism, Heritage and Culture on the Government of New Brunswick website and in the
Department’s Annual Report.
I understand that failure to adhere to these conditions will result in my organization being
disqualified from receiving future grants from the Commemorations and Celebrations program.
Name of Applicant (Please print)
Signature (Applicant)
Title
Date
Send applications to:
Heritage Branch
Department of Tourism, Heritage and Culture
20 McGloin Street
P.O. Box 6000
Fredericton, NB E3B 5H1
or e-mail to:
thctpcinfo@gnb.ca
Page of 4