Grant Application Form

Brokenhead River Community Foundation

Grant and Funding Guidelines
The Brokenhead River Community Foundation makes grants to enhance the quality of life in all areas of the community. Citizens of Beausejour-Brokenhead benefit from grants made in the following areas:
- Arts, Culture and Heritage
- Literacy and Education
- Health, Wellness and Recreation
- Children, Youth and Families
- Environment and Animal Welfare
Additional Grant - Winter Games Legacy Grant

The Winter Games Legacy Grant will be available to local teams and organization associated with sports involved in the Winter Games held in Beausejour in 2006; Alpine Ski, Badminton, Special Olympic Bowling, Cross Country Skiing, Curling, Hockey, Volleyball, Figure Skating and Artistic Gymnastics. Where these sports do not apply, the grant may go to any sport involved with the current Winter or Summer Manitoba Games program. The intent of the grant is to assist with equipment (excludes uniforms), clinics for athletes and coaches, hosting or attending major sporting events.

To meet the changing needs of the community, guidelines for grant applications are established and reviewed annually. Applications for grants are thoroughly reviewed by a volunteer Grants Committee, and approved by the Board of Directors.

Eligibility

Only community organizations that are non-profit may apply. Organizations applying must have access to a registered charity number. (Town of Beausejour or RM of Brokenhead charity numbers can be used - please contact them to make arrangements). Grants are not to be made to individuals or businesses.

Granting Priorities

The Foundation gives preference to projects and programs where grant money can benefit the community in a significant way. Proposals should:
- serve a need in the community
- involve organizations in the community
- strengthen the social and cultural structure of the community
- emphasize and utilize the skills and resources that exist in the community
- have a well-planned approach - have broad public appeal
- be working in partnership or collaboration with other community partners
- include the organizations demonstration of financial commitment towards the project (minimum 25% of project)
Restrictions

Grants for the following will NOT be approved:
- research
- seminars, conferences, or workshops
- tours or travel outside the community
- sectarian, religious, or political purposes
- fund raising activities
- core operating costs or capital building campaigns
- to retire debt
- capital projects located outside the Beausejour or Brokenhead area
- general endowment or sustaining funds
Funding Procedures

Prior to receiving funding, successful applicants must submit a post event report, complete with photos of the project and the final project budget by August 31st. The final project budget must include the actual expenses and revenues, as well as paid receipts (or photocopies of same). A small sign will be given to successful applicants to be displayed at their project for no less than a year.

Application Deadline:

Postmarked or hand-delivered by September 30th - no exceptions.
I understand and agree to the above Grant and Funding Guidelines.

Clear
Name

First NameLast Name

Brokenhead River Community Foundation

Grant Application - Page 1 of 5
Organization Information:

NOTE: A copy of your Organizations most recent financial statements may be requested, and information regarding your project may be made available to our donors and to the public.
Name of Organization:
Organization Business Number
Province of Manitoba Business Registration Number - for CRA purposes
Contact Person:
First and Last Name
Title:
Email
example@example.com
Address

Mailing Address

Street Address

CityState / Province

Postal / Zip Code
Cell Phone:
Please enter a valid phone number.
Home Phone:
Please enter a valid phone number.
Work Phone:
Please enter a valid phone number.
Website:
Years Established:
List of Board of Directors or members of the governing body for your organization:
Charity Registration Number:
Charity Number belongs to:

Brokenhead River Community Foundation

Grant Application - Page 3 of 5
Project Information Continued:
Provide a description of your project:
What is the purpose of this project? What is the relationship of the project to the overall goals and services of your organization?
Demographics
Who will be served by this project? How many will be served? What is the geographic area served?
Diversity/Accessibility
If this project impacts people of diverse needs, please specify which groups:
Financial/Community Support

Please note: The Brokenhead River Community Foundation will only support 75% of the total program/project cost.

List community partners and sources of funding for the project (this can include Gift in Kind Items as well):

	Sources	Confirmed Amount	Expected Amount	Gift in Kind Value
1
2
3
4
5
6
7
8
Total:

Use of local resources: (Will materials be purchased locally? Will local tradespeople be utilized?):
Explain if and how this project promotes volunteer participation and citizen involvement?
FUTURE FUNDS: If this is not a one time program or capital project, is there active planning for continuation of the project beyond initial funding?
Other: Is there anything else you would like us to know about this project? Attach additional information if necessary.
Are you willing to acknowledge the Brokenhead River Community Foundation for their financial support towards this project/program? If so, explain how:
File Upload

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Brokenhead River Community Foundation

Grant Application - Page 4 of 5
Project Budget

Please give a detailed outline of your project budget. Do not include the overall operational expenses of your organization - only the particulars related to the proposed project. If your project is being completed in phases, only provide the budget for the current phase. NOTE: project expenses and sources of revenue should balance. Quotes are expected for capital projects and equipment purchases.

Project Expenses

	Expense	Amount
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Total Expenses

Sources of Revenue:

	Confirmed (a)	Unconfirmed (b)
Amount Requested from BRCF
Funding on Hand
Other Sources of Revenue (list)
Source 1
Source 2
Source 3
Sub Total
Total Funds (a+b)

List additional sources of revenue noted above (Source 1, Source 2, Source 3, if applicable):

Brokenhead River Community Foundation

Grant Application - Page 5 of 5
We, the undersigned, declare that we are Officers of this Organization and have been authorized to make this application on behalf of the Organization.

By signing this application, the applicant agrees to the expectations of grant recipients and gives BRCF permission to publish grant information upon approval of the grant. Grant applications which are not approved will remain confidential.

Signature of First Signing Officer
Name:

First NameLast Name
Position:
Signature:

Clear
Date:

MonthDayYear
Date

Signature of Second Signing Officer
Name:

First NameLast Name
Position:
Signature:

Clear
Date:

MonthDayYear
Date
Should be Empty:

Brokenhead River Community Foundation

Brokenhead River Community Foundation

Brokenhead River Community Foundation

Brokenhead River Community Foundation

Demographics

Diversity/Accessibility

Financial/Community Support

Brokenhead River Community Foundation

Brokenhead River Community Foundation