Community Grant Nomination and Application Form
Provide your contact details and describe your grant purpose, amount, and payee information.
Are you nominating yourself or someone else?
*
I am nominating myself
I am nominating someone else
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Nominee's Full Name
*
First Name
Last Name
Nominee's Email Address
example@example.com
Nominee's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Amount Requested (CAD)
*
Purpose of the Grant Funds
*
Payee Name (who will receive the funds)
*
Payee Contact Information
*
Reason for Grant Request
*
May we contact the nominee if necessary?
Yes
No
Submit Nomination
Should be Empty: