"Go Nb Provincial Women in Leadership Grant Application Form" - New Brunswick, Canada

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Download "Go Nb Provincial Women in Leadership Grant Application Form" - New Brunswick, Canada

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2019-2020
GO NB Provincial Women in Leadership Grant Application Form
SECTION 1. Lead Applicant Information
Organization name:
Contact person for the request:
Name of president or chair of organization:
Mailing Address:
Telephone number:
Email:
About your organization.
Type of organization?
Provincial Sport Organization
Multi-sport/Recreation Organization
Other provincial not for profit organization - please specify:
Do you have liability insurance for this project?
Yes
No
Please provide proof of insurance with your application
SECTION 2. Project information
Basic Project Information
Name of project:
Start date:
End date:
Has your board endorsed this proposal?
Yes
No
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Reset
2019-2020
GO NB Provincial Women in Leadership Grant Application Form
SECTION 1. Lead Applicant Information
Organization name:
Contact person for the request:
Name of president or chair of organization:
Mailing Address:
Telephone number:
Email:
About your organization.
Type of organization?
Provincial Sport Organization
Multi-sport/Recreation Organization
Other provincial not for profit organization - please specify:
Do you have liability insurance for this project?
Yes
No
Please provide proof of insurance with your application
SECTION 2. Project information
Basic Project Information
Name of project:
Start date:
End date:
Has your board endorsed this proposal?
Yes
No
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Woman in Leadership Initiative Details
Please describe what makes the initiative special by answering the following questions.
Why is this out of the ordinary?
Why does it require additional funding?
By what margin are women and girls underrepresented?
How will it contribute to the goal of increasing participation of women and girls in sport?
(attach appendix if additional space required)
Please contact
info@coachnb.ca
or your national sport organization for information on coaching courses.
Objectives
Please indicate the number of participants who will receive certification / training:
Estimated number of coaches
Estimated number of officials
Estimated number of leaders
Partners
What partners have you identified to support the project? (i.e. people to help out, school, district, municipality,
Provincial Sport Organization, etc.) Please list your partners and their role and/or qualifications in the delivery
of your project.
Partner
Contact person
Role
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SECTION 3. Budget Information
Budget
Estimated Revenues
Amount
Estimated Expenses
Amount
Items
Items
TOTAL
TOTAL
$ 0.00
$ 0.00
$ 0.00
Total Amount Requested:
SECTION 4. Completion of Application
Accountability Declaration of Partners
I, the undersigned, am authorized by my organization to forward this application. The information presented in
this application is, to the best of our knowledge, true and correct.
Furthermore, in the event that our application is successful, we agree to:
1. Receive and account for all project funds, through the Lead Organization.
2. Participate in evaluation / monitoring activities related to the project.
3. Provide proof of insurance coverage for the project and its participants.
4. Ensure project is implemented and that all obligations for reporting are met.
5. Ensure that a final activity report is submitted 30 days after the project is completed.
Signature of Applicant:
Date:
Please submit completed applications by email at sr/sl@gnb.ca; fax to 506-453-6548 or mail to:
Marysville Place, P. O. Box 6000, Fredericton, NB, E3B 5H1
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