ProVision Fund
Initial Fund Request
Please fill out and submit the information below (Submit button can be found at the bottom of this form).
Register for EFT (EFT registeration does not get submitted in this form, please download fillable PDF, fill in PDF form and email it to the address below).
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Grant to be made payable to:
*
Community of Faith / Network / Cluster
Name of Program
*
Grant Application Number
*
This information can be found on your grant approval letter.
Program Start Date
*
-
Month
-
Day
Year
Date
Program End Date
-
Month
-
Day
Year
Date
Please select type of request
*
First 75% of total grant amount
First year grant (if project was funded for more than one year)
Other
If you selected "Other" on the question above, please specify:
Total Amount of Approved Grant
*
Amount to be Paid
Register for EFT
The ProVision grant is paid by Electronic Funds Transfer (EFT).
Download
direct deposit fillable PDF form by clicking here.
Fill in form and save your answers.
Email
your filled in EFT form to
finance.pacificmountain@united-church.ca
I acknowledge that:
*
I have downloaded the EFT form above and it will be emailed to finance.pacificmountain@united-church.ca.
Submit
Should be Empty: