Healing Pathways Community Funding Applications

Healing Pathways Community Funding Grant Report
We hope that your project was a great success. As a recipient of the Healing Pathways, NSHPCA Community Funding, a grant report is due for submission on January 15th, 2024. Please fill out the information requested below.

Funding recipients must complete this report to be considered for future funding. If you have any questions you can contact us at funding@nshpca.ca or by phone 782-321-9448.
Privacy
The Nova Scotia Hospice Palliative Care Association (NSHPCA) is committed to protecting the privacy and confidentiality of personal information collected through this report as part of the Healing Pathways Community Funding Program. All information is collected, used, and stored in compliance with the Personal Information Protection and Electronic Documents Act (PIPEDA).

By completing this report, you are providing your consent to the collection and use of your personal information for purposes such as assessing applications, communicating with applicants, and evaluating program outcomes. Your information will not be shared with third parties without your consent, except as required by law. You have the right to access, correct, or withdraw your information at any time.
Organization Information:
What is the registered name of applicant organization?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please share the civic address of applicant organization, if different from mailing address.
Phone Number*
E-mail*
example@example.com
Please list the organization's website.*
Who is the primary contact person for this application and what is their role in the organization?*
What is the primary contact person's phone number and email if different from above?
Project Information
Please describe your project, the impact it had on the community and how it supported grief, bereavement and/or emotional wellness.*
We ask that you report on any surveys, interviews, etc. that you used to demonstrate success, and please share the results. *
Please share some of your accomplishments and/or success stories.*
List a few testimonials from those working in the project and/or those who have benefitted from it.*
If possible, please share a few photos of your project in action. Please ensure you have permission from those featured in the photograph. Files can be uploaded in the "File Upload" box below.*
File Upload

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Total Project Budget

In this section please list the BUDGET (planned) cost and then ACTUAL Cost.
Project-specific equipment, materials and supplies (BUDGET and ACTUAL):*
Project-specific software or other technology (BUDGET and ACTUAL):*
Project-specific staffing (BUDGET and ACTUAL):*
Project-specific rent or mortgage (BUDGET and ACTUAL):*
Project-specific equipment, materials and supplies:*
Project-specific utilities (BUDGET and ACTUAL):*
Project-specific travel and meeting expenses (BUDGET and ACTUAL):*
Other project-related costs (BUDGET and ACTUAL):*
Subtotal Direct Project Expenses (BUDGET and ACTUAL): *
General or administrative expenses (up to 10% of project expenses) (BUDGET and ACTUAL):*
Total Project Cost (BUDGET and ACTUAL): *
If extension of use of funds was requested and approved please explain the remaining project costs and include date agreed upon with NSHPCA. Note: Any remaining funds over $50.00 must be reported on in this final report and returned to NSHPCA by March 31, 2025.*
Submitting Your Report

Please make sure you have completed all information required. If there are attachments such as photos, testimonials or additional documentation please upload them in the box below.
File Upload

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Healing Pathways Community Funding Grant Report

Privacy

Organization Information:

Project Information

Total Project Budget

Submitting Your Report

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