Stensrud Family Top of The Rock

Activity Information
Please describe the desired activity/trip. How will you be travelling to the location and where will you be staying (if applicable)? *
Activity Start Date*

MonthDayYear
Activity End Date*

MonthDayYear

Financial Information

Remember to provide all costs in Canadian dollars. Applicant contributions are set at a minimum of 5% (exceptions may be made). By contributing greater than 5% of the total cost, SFTOTR can provide more funding to more applicants. Applicant contributions play a significant role in the approval process. If required, be sure to pay attention to travel necessities (such as passports, travel insurance, currency exchange rates, etc.). Average funding is a lifetime value of $2,000 per applicant. If you are uncertain if the applicant has received funding previously or the amount, please contact Cosmo for this information.
How much will the transportation cost for all applicants and caregivers?*
If driving, will you be supplying your own vehicle or renting? Vehicle insurance must be in place or purchased*
If applicable, how much will the accommodations cost?
How much will the activity/admission cost?*
How much will the meals cost?*
Are there any other costs expected?*

YesNo
If yes, for what expenses?
Other Costs ($)
Total Cost ($)*
How much will the applicant contribute to the cost? A minimum of 5% of the total cost is required from the applicant. Exceptions may be considered.*
Total Foundation Request ($)*

Process and Notices
If your application is approved:
- You will receive a letter confirming what has been approved.
- Contributions must be submitted prior to being reimbursed.
- The person applying for funding acknowledges they will be responsible to pay for the activity/trip themselves.
- Upon submission of all original receipts and contributions, applicants will be reimbursed accordingly to what was approved.
- All efforts will be made to distribute funding within 15 days of submission of receipts.
If your application is not approved:

You will receive a letter stating the rejection. The foundation may request additional information regarding your application.
Do you have all necessary travel documentation (such as passports, travel insurance, etc.)?*

YesNoOther
If you are a Cosmo employee, have you informed your immediate supervisor of your proposed activity's dates?*

YesNo
Is the caregiver(s) incurring any direct costs through the generous donation of their time (such as childcare, loss of pay, etc.)?*

YesNo
If so, how much?
Today's Date*
Signature*

Clear
Printed Name*

First NameLast Name
Should be Empty:

The Stensrud Family Top of The Rock Application Form