"Strategic Initiatives Fund (Sif) Application Form" - New Brunswick, Canada

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Download "Strategic Initiatives Fund (Sif) Application Form" - New Brunswick, Canada

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D
T
, H
,
C
EPARTMENT OF
OURISM
ERITAGE
AND
ULTURE
S
I
F
(SIF)
TRATEGIC
NITIATIVES
UND
2019-2020
A
PPLICATION FORM
Definition: For the purposes of this program, an initiative can be defined as a project, an event or an activity.
PART A – Applicant Information
Name of organization:
Title of Initiative:
Proposed schedule of events (start/end):
Name of Chairperson:
Name of Contact person:
Title:
Address:
Tel.:
Fax:
Email:
Website:
Total Budget for this Initiative: $
Total Grant Requested: $
Note Grant requested must not exceed 50% of total eligible expenditures
.
Select one component:
Component 1 – SIF - Strategic Growth and Development
Component 2 – SIF - Market Access
1
D
T
, H
,
C
EPARTMENT OF
OURISM
ERITAGE
AND
ULTURE
S
I
F
(SIF)
TRATEGIC
NITIATIVES
UND
2019-2020
A
PPLICATION FORM
Definition: For the purposes of this program, an initiative can be defined as a project, an event or an activity.
PART A – Applicant Information
Name of organization:
Title of Initiative:
Proposed schedule of events (start/end):
Name of Chairperson:
Name of Contact person:
Title:
Address:
Tel.:
Fax:
Email:
Website:
Total Budget for this Initiative: $
Total Grant Requested: $
Note Grant requested must not exceed 50% of total eligible expenditures
.
Select one component:
Component 1 – SIF - Strategic Growth and Development
Component 2 – SIF - Market Access
1
PART B – Proposal Outline
Note: Proposals will be evaluated based on the following information. Please use the guidelines and
suggested headings below to formulate your proposal.
1. Briefly describe the initiative. Please refer to the program guidelines for examples of eligible initiatives. Choose
Component 1 or 2.
2. Describe the anticipated impact on your organization or the arts and culture sector. For example, does the
initiative:
• Improve the professionalism of your organization and/or the arts and culture sector?
• Involve partners? What are their roles?
• Involve professional artists? What are their roles?
• Provide new visibility, develop a more sustainable audience, or create an export opportunity for your
organization and/or its membership?
• Develop new sources of funding or revenue for the organization?
3. Describe the potential economic impact of the initiative (where applicable).
4. Provide a timeline showing the major milestones of the initiative (where applicable).
5. Will this initiative depend on recurring funding from the Department of Tourism, Heritage and Culture to
succeed? If yes, please explain how the project will evolve over time (e.g. create employment or increase
revenues for artists; increase participation in artistic and cultural activities; etc.)
6. Please describe the longer-term impact the initiative will have on your organization or the arts and culture
sector.
7. Provide a detailed, balanced budget showing total expected expenses and revenues (funds and in-kind) from
all sources, including the applicant’s. Please use the budget table provided in Part C of this form as a guide.
8. Describe how you will measure/evaluate the success of the project. Please describe what you will measure and
how you will measure it. Examples include (but are not limited to):
• Attendance and/or participation; or growth in attendance and/or participation
• Volunteer participation (if applicable);
• If the initiative involves training/professional development/skills development for staff or board
members, please describe how you will measure the impact of the training;
• If the initiative involves the development of a strategic plan or business plan, please describe how the
implementation and success of the plan will be monitored;
2
• New sources of funding or revenues the initiative will help the organization access, and how these will
be measured.
• New export and presentation opportunities created in domestic or international markets.
A final report is due 30 days after conclusion of the initiative. Please refer to the Final Report form on the
department website as a guide and be sure to provide all the required information.
Please note that failure to provide a final report will result in your organization qualifying for future grants
from the Arts and Cultural Industries.
PART C – Budget
R
.
EVENUE PROJECTIONS MUST INCLUDE THE AMOUNT OF THE GRANT REQUESTED
R
(0). I.
.
EVENUES MINUS EXPENSES MUST EQUAL ZERO
E
MUST BALANCE
P
E
$
ROJECTED
XPENDITURES
Specify only the office expenses that relate to the coordination costs of the
activity:
Salary and benefits
Stationary, copying, mailings, etc.
Travel / meetings
Telephone, fax, and other related costs
Artist fees
Artist expenses (including travel, accommodation, and per diem)
Technical, presentation and production fees
Equipment rental
Venue rental
Security
Production costs (if not included above)
Other production, presentation expenses (specify):
Advertising and promotion salaries and fees (web, radio, social media, other)
Brochures, posters & program
Any other promotional costs (please specify):
Miscellaneous (insurance, etc., please specify)
Total expenditures (Must equal revenues)
$
3
P
R
$
ROJECTED
EVENUES
P
LEASE ADD LINES IF REQUIRED
Federal government (specify)
Provincial government (specify)
Include the grant amount requested. 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
Ticket sales
Merchandise / Bar / Concessions' Sales
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
• Other (specify)
Total Revenues (Must equal total expenditures)
$
Grant Requested (please record this amount on page 1 as well)
$
N
: T
50%
OTE
HE GRANT REQUESTED MUST NOT EXCEED
OF THE TOTAL ELIGIBLE
.
EXPENDITURES
Grant awards will be based on project merit against the criteria, on the number of applicants, and on the
amount of funds available. To manage applicant expectations, the Department emphasizes that grants
will not necessarily be awarded at the full amount requested. Not all eligible applicants will receive a
grant.
First-time applicants do not generally receive maximum levels of support. Please contact the Program
Consultant to discuss the application and requested amount.
A final report is due 30 days after conclusion of the initiative. Please refer to the Final Report form on the
department website as a guide and be sure to provide all the required information.
Please note that failure to provide a final report will result in your organization being disqualified from
receiving future grants from the Arts and Cultural Industries.
PART D – Declaration
I hereby agree to provide all requested information as well as any other supporting documents needed to evaluate
this application. I understand that my application may be disqualified if it is incomplete.
I recognize that applications are approved subject to availability of funds and that, beyond the provision of a grant, the
Province of New Brunswick has no further commitment to the applicant. The Province will not be held responsible for
the completion of an activity.
4
I agree to acknowledge the financial participation of the Province of New Brunswick in all publicity related to the
activities of the proposed project. Most current provincial logos can be downloaded HERE.
I agree that my project should be completed by March 31
of the current fiscal year and that a final report will be
st
submitted to the Department after the project is completed.
I certify that this organization is incorporated in New Brunswick, that I have signing authority for the above-named
organization, that the Board of Directors has reviewed and approved this application and that, to the best of my
knowledge, the information provided with this application is accurate and complete.
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.
Name : ____________________________________________ Position / Title : ______________________________________
Signature : ________________________________________ Date : ____________________________________________
P
,
,
:
LEASE SEND THIS FORM
AS WELL AS YOUR APPLICATION DOCUMENTATION
VIA EMAIL TO
culture@gnb.ca.
A
:
PPLICANT CHECK LIST
Completed, and dated application.
Attached documentation (if any).
Copy of the constitution, letters of incorporation or letters patent as well as a list of current Board
members, titles, and phone contact. (if first-time applicant).
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