Required fields are marked with asterisks (*)

Town of Halton Hills' Community Partnership Program

Community Partnership Program

2022 APPLICATION

* Required fields for successful Community Partnership Program application submission.

Should you have any questions while completing the application, please contact our Community Development Supervisor at 905-873-2600 Ext. 2273.

Here is a link to the Community Partnership Guidelines for reference:
Community Partnership Program Guidelines

Applicant Information:

What is the legal name of your organization?

Your organization's signatory contact is the person who has signing authority to legally bind your organization, has authorized this application and will be responsible for signing a Community Partnership Program agreement. The Town of Halton Hills requires 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 attach a copy of your organization's most recent completed financial statements. 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.

Please attach a copy of your organization's most recent completed financial statements.

Browse…

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

I confirm that the organization’s financial statement provided is correct, up-to-date and complete.

Yes

Please attach a copy of your organization's detailed budget including projected in-kind support, revenue and expenses (with copies of quotes).

Browse…

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

I confirm that all the organization’s project budget provided is correct, up-to-date and complete.

Yes

Specify your funding request from the Community Partnership Program (multiple funding streams can be requested to a combined total of up to a maximum of $5000):

Funding Stream

Organizational Effectiveness

Items You are Requesting Funding For

Funds Requesting

Funding Stream

Municipal Support

Items You are Requesting Funding For

Funds Requesting

Funding Stream

Community Projects

Items You are Requesting Funding For

Funds Requesting

Funding Stream

Neighbourhood Projects

Items You are Requesting Funding For

Funds Requesting

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.

Describe and disclose all grants and/or funding sources that your organization will have for the proposed project:

Funding Source (include cash or in-kind)

Funds amount (secured or pending)

Funding Source (include cash or in-kind)

Funds amount (secured or pending)

Funding Source (include cash or in-kind)

Funds amount (secured or pending)

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

Additional Information:

An email of your request will be sent 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.

Online Forms

Town of Halton Hills' Community Partnership Program

Community Partnership Program

2022 APPLICATION

Applicant Information:

#1 Signatory contact details:

#2 Signatory contact details:

Project Information:

Financial Information:

Additional Information: