The application form, grant proposal, and other required documents, must be submitted electronically using this online application form, prior to May 1st or October 1st of the current year.


SECTION A: APPLICANT INFORMATION


All fields identified by an asterisk (Required) are mandatory














SECTION B: BRIEFLY DESCRIBE YOUR CLUB (400 WORDS OR LESS)


All fields identified by an asterisk (Required) are mandatory


NOTE: Include specific details such as how many youth are served, the types of social issues that are addressed and specific needs for your youth, the number and types of programs that the club offers, the number of volunteers at the club, the club's history, how the club has expanded over the years, etc.


SECTION C: PROGRAM / PROJECT DETAILS


All fields identified by an asterisk (Required) are mandatory





















SECTION D: PROGRAM / PROJECT DESCRIPTION


All fields identified by an asterisk (Required) are mandatory


Please provide a general overview of the program / project below which outlines the purpose, the community needs to be addressed, and the key program / project goals.




















Please provide details on the activities that will take place as part of this program / project.







SECTION E: RESULTS


All fields identified by an asterisk (Required) are mandatory


NOTE: Outcomes are the changes that occur or the difference that is made for your Club members because of this program / project. Outcomes relate to changes in behavior, knowledge, attitudes, motivation, skills, conditions or other expected results.






SECTION F: ADDITIONAL INFORMATION


All fields identified by an asterisk (Required) are mandatory




SECTION G: PROGRAM / PROJECT BUDGET


All fields identified by an asterisk (Required) are mandatory




PROGRAM / PROJECT EXPENDITURES

AMOUNT



$  



$  



$  



$  



+ Add expenditure

TOTAL EXPENDITURES

$0.00






NOTE: Include all gifts in-kind to the program / project. Budget revenue should demonstrate community support and additional specific sources or support.


SPECIFIC SOURCES OF REVENUE CONFIRMED ANTICIPATED TOTAL
 

$  

+$  

  =  

$  

+$  

  =  

$  

+$  

  =  

$  

+$  

  =  

+ Add expected revenues

 
TOTAL EXPECTED REVENUE $0.00 $0.00 $0.00

 
TOTAL PROGRAM / PROJECT SHORTFALL
 
$0.00 - $0.00 = $0.00

SECTION H: AMOUNT REQUESTED


All fields identified by an asterisk (Required) are mandatory




SPECIFIC DETAILS

AMOUNT



$  



$  



$  



$  



+ Add specific details


TOTAL AMOUNT REQUESTED

$0.00


To ensure that your application is complete, please review the following checklist prior to submitting your grant application.

  • All information required in section A is provided
  • All questions in sections B,C,D,E,G and H are completed in full
  • Budget is complete with specific areas of expenditure and sources of revenue indicated
  • Total expenditures and revenues are balanced or clearly indicate the shortfall of the program / project
  • Up-to-date financial statements are attached


ATTACHED FILES (PDF)