Northern Savings Credit Union - Community Funding Application

1
Organization name* This field is required.
2
About the organization
Date Established
Charitable tax number (if applicable)
3
Does the organization have an account with Northern Savings?* This field is required.
YESNO
4
Organization address* This field is required.
Street Address
City
Province
Postal Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Organization phone number* This field is required.
Please enter a valid phone number.
6
Organization email* This field is required.
example@example.com
7
Organization website
8
Contact name* This field is required.
First Name
Last Name
9
Relationship to the organization* This field is required.Applicants role with the organization applying for funding
10
Contact information* This field is required.
Phone number
Email
11
Preferred method of contact* This field is required.
Phone
Email
12
Name of project/initiative* This field is required.
13
Description of project/initiative* This field is required.(include history/previous sponsors)
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14
Purpose and goals of project/initiative* This field is required.
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15
Objectives of project/initiative* This field is required.
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16
Projected timeline* This field is required.
Start Date
End Date
17
Benefit areas of the project/initiative* This field is required.Select all that apply
Arts & Culture
Community Event
Education
Diversity, Equity, Inclusion
Financial Literacy
Healthy Lifestyles (sport, health and / or human services)
Truth & Reconciliation
18
Geographic region(s) that the project/initiative targets* This field is required.
Prince Rupert
Terrace
Haida Gwaii
Other
19
How do you plan to measure your success?* This field is required.
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20
What other organizations are involved and/or providing funding and at what level?* This field is required.
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21
Project/initiative budget* This field is required.
Total Budget
Amount requested
22
Type of request* This field is required.Select all that apply
Funding
Giveaways
Volunteers
Other
23
Has Northern Savings sponsored this project/initiative in the past?
Please Select
Please Select
Yes (please indicate in next section)
No, but Northern Savings has sponsored a different project / event with our organization
No, we have not received sponsorship from Northern Savings in the past
If yes, when did we sponsor your event?
If yes, what was the amount sponsored?
24
What are the expectations or opportunities for Northern Savings’ participation?* This field is required.
Recognition
Event participation
Speaking opportunity
Other
None
25
How will you recognize Northern Savings’ sponsorship (e.g. publicity, promotion, advertising)* This field is required.
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26
Have you been in touch with anyone from Northern Savings regarding this application?* This field is required.Please list.
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27
Please include any additional information relevant to the application
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If you have any questions or inquiries, please email info@northsave.com or send us a message through our website. Thank you for your submission.
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