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Funding Request
General Information
Name of organization
*
Charity Registration Number
Primary Contact
*
Mr.
Mrs.
Prefix
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Organization website, if applicable
Mission
*
Board members and their function
Project Information
Name of project
Description of project
Area of focus
Wellness activity
Psychosocial support
Therapeutic intervention
Housing
Other
If other, please specify
Amount requested
*
Start Date
*
/
Day
/
Month
Year
Date
End Date
*
/
Day
/
Month
Year
Date
Describe the specific need(s) your project aims to address.
Target beneficiaries
Male veterans
Female veterans
Mixed
Number of beneficiaries
Number of sessions
Describe the beneficiaries of the project.
How will beneficiaries be recruited and/or selected?
Will beneficiaries be required to pay to take part in the project?
Geographic location
Describe two (2) goals of the project.
Describe two (2) anticipated challenges of the project and how they will be addressed.
How will you measure the success of your project?
If this is not the first year, please provide results from previous years.
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How will the project be sustained beyond funding from the Quebec Veterans Foundation?
Please list the formal partnerships and/or additional sources of revenue established for this project.
Please attached a detailed timeline and budget for this project.
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