StellerImpact Application

1
Do you understand our focus of supporting local groups and organizations?* This field is required.
YESNO
2
Your Name* This field is required.
First Name
Last Name
3
Name of the group / organization you are representing* This field is required.This is the name that will appear on the Cheque of an approved request
4
Email* This field is required.Approval notice and/or requests for more info will be sent by email
example@example.com
5
Phone Number* This field is required.
Please enter a valid phone number.
6
Please select the branch(es) that your organization banks with* This field is required.
Cranbrook
Castlegar
Fernie
Sparwood
Elkford
Greenwood
Slocan Park
None
7
What can we call your project?* This field is required.Give us a title for it if you can
8
Is there a website we can visit as reference for the project or organization?* This field is required.N/A if no. If yes, please type it in below.
9
What is your specific role in the project, and who are some other key people involved / what are their roles?* This field is required.
10
Please explain what the project is, and why it is happening now. * This field is required.
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11
Please explain who the project will impact, and how.* This field is required.
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12
Please explain what will make this project a success.* This field is required.Can you measure this?
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13
Where is this project going to happen?* This field is required.
14
What cities / regions will this project directly benefit?* This field is required.
Cranbrook
Castlegar
Fernie
Sparwood
Elkford
Greenwood
Slocan Park
Other
15
How much funding are you requesting from StellerVista?* This field is required.Amounts between $1000 and $5000 only for this program.
16
What percentage of the full project does this cover?* This field is required.
17
Please list any other funding partners you have for grants or donations in this project. * This field is required.
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18
Can you include a basic point form, full, budget of this project, and indicate which items the StellerVista funding would go towards* This field is required.
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19
Are any other financial institutions involved?* This field is required.
YESNO
20
Will this project happen without a donation from StellerVista?* This field is required.
YESNO
21
For what date are you requesting funds?* This field is required.When do you need the cash in hand?
Date
Year
Month
Day
22
What is the official start date of this project?* This field is required.When do you need the cash in hand?
Date
Year
Month
Day
23
When do you anticipate completion of the project?* This field is required.When do you need the cash in hand?
Date
Year
Month
Day
24
Which area(s) do(es) this project align with?* This field is required.
Access to Housing
Financial Literacy
Environmental Sustainability
Family & Youth Programs
Reconciliation
Vulnerable Populations
Other
25
How would a StellerVista donation be recognized by your organization?* This field is required.Is this something you would promote / take photos of / etc
26
Will you be able to send StellerVista photos and/or video of your project and the efforts leading up to its successful conclusion?* This field is required.
YESNO
27
Can StellerVista visit the project, at a future date, to take photos and/or videos to share online, in-branch, and trough other media sources?* This field is required.
YESNO
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