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Town of Halton Hills' Community Partnership Program

2023 APPLICATION QUESTIONS FOR COMMUNITY PROJECTS

Applicant Information:

What is the legal name of your organization?

Your organization's signatory contacts are the people who have signing authority to legally bind your organization, have authorized this application and will be responsible for signing a Community Partnership Program agreement. Please provide contact details (name, position, email, and phone) for TWO signatory contacts.

#1 Signatory contact details:

Signatory 1: Name

Signatory 1: Position

Signatory 1: Email

Signatory 1: Primary Phone

#2 Signatory contact details:

Signatory 2: Full Name

Signatory 2: Position

Signatory 2: Email

Signatory 2: Primary Phone

I confirm both representatives listed above have designated signing/decision-making authority and are identified as signatory contacts within the organization and have authorized this application.

Yes

Your organization’s contact is the designated person who has the authority to submit this application.

Your organization contact's details:

Full Name

Position

Primary Phone Number

Please provide a brief description of your organization’s/group’s mandate and history.

Project Information:

What is the name of your activity/event/initiative?

Describe your activity/event/initiative. Please include key dates and scheduled activities.

Which Partnership Priority does your activity/event/initiative fit into?

Active Living

Community Wellbeing

Community and Neighbourhood Engagement

Explain how your activity/event/initiative supports the Partnership Priority indicated above.

Explain the need for your activity/event/initiative in Halton Hills? How will your project benefit the community?

What steps has your organization made to ensure sustainability of this activity/event/initiative for the future?

Describe any collaborative efforts or partnerships your organization has developed for the purpose of this project.

Indicate how your activity/event/initiative has been made accessible, inclusive and affordable to participants.

What are the anticipated outcomes, benefits, or results of your project?

How is your activity/event/initiative innovative or unique?

Financial Information:

Please submit TWO separate budgets along with your application:

The first detailing your organizational budget for 2023. If you have a surplus or deficit, include your surplus explanation or deficit reduction plan. Please ensure you are submitting the required financial statements based on your organization's fiscal year-end date and total revenues.
The second detailing the budget for your proposed project or event. Please include in-kind support, revenue, and expenses.

Please attach a copy of your organizational budget for 2023

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg,

Please attach a copy of the budget for your proposed project or event

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg

Please specify the amount of support your organization is asking for:

Explain how your organization will use the Community Partnership Program funding to support your activity/event/initiative.

Describe all additional grants and/or funding sources that your organization has explored for this project

Of the grants and funding sources you've researched, please describe all funding that your organization will receive for the project:

Total Amount Requested from Other Sources

Are you charging an admission fee?

yes

Acknowledgements:

I understand the importance of avoiding any conflicts of interest (or the appearance thereof) when obtaining goods and/or services.

I understand that should this application be approved for Community Partnership Program funding; our organization will be required to enter into an agreement with the Town of Halton Hills that is based on the information in this application.

I agree that if this project is approved for Community Partnership Program funding, we will publicly recognize the Town of Halton Hills.

I have read and understand all information contained within the Community Partnership Program guidelines.

I understand that the Town of Halton Hills will not reimburse any expenses incurred prior to being notified of funding approval.

I understand the information collected on this form is collected in accordance with the Municipal Freedom of Information and Protection of Privacy Act and will be used for the purpose of processing this application and, if approved, administration of the program.

The information contained in this application and in the accompanying documents is true, accurate and complete.

I hereby certify that the information contained in this application is accurate and complete.

Clear

Applicant's position on Executive

Date

A copy of your application will be emailed to you. Please check your junk mail folder if you do not receive a copy in a timely manner.

Please Note: This is not approval. It is a request form only. Community Development Staff will follow up regarding next steps in the approval process.

By submitting this form, you certify that the information you have provided above is true and correct.

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