Boys and Girls Clubs of Canada Grant Application Form

Section A: Applicant information

Please complete all fields with the exception of fields indicated as (optional).

• Name of the organization*
• Address*
• Canada Revenue Agency charity registration #*
• Club's Executive Director*
• Website (optional)

• Please fill out the contact person’s information

• Name*
• Position*
• Telephone*
• Email*

Section b: briefly describe your club

Describe the ways in which your club interacts with the local community and the community's youth. (500 words or less)

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

• Name of program/project*
• Brief description of the program/project (specify how you will use the grant).*
• Estimated number of weeks needed to complete the program/project.*
• Estimated number of participants in the program/project.*
• Anticipated program/project start date (mm/dd/yyyy)*
• Anticipated program/project end date (mm/dd/yyyy)*

Section D: Program / Project description

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.

• a) Purpose of program/project*
• b) Community needs to be addressed*
• c) Key program/project goals*

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

• List of activities*

Section E: Impact

NOTE: The impact is a direct result of the positive outcomes or the difference that is made for your Club members because of this program / project. Outcomes relate to change in behavior, knowledge, attitudes, motivation, skills, conditions or other expected results.

• Expected outcomes for participants*
• Expected outcomes for your organization and community*

Section F: Additional information

Please provide any additional details that we should know when considering your application for funding.

• *

Section G: Program / Project budget

Please outline below, the program/project's expenditures.

• *

  Program/project expenditures	Amount

• Please outline below, in detail, the confirmed and anticipated sources of funding for your program / project, other than the amount requested from the R. Howard Webster Foundation.

  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 anticipated revenue	Amount

• *

  Specific sources of confirmed revenue	Amount

• Please review the following calculated program/project expected revenue and shortfall.

  NOTE: Review the previous entries if the results are not as expected.

  Campaign/project shortfall

• • Total anticipated revenue
  • +
  • Total confirmed revenue
  • =
  • Expected revenue
• • Total expenditures
  • -
  • Total confirmed revenue
  • =
  • Shortfall

Section H: Amount requested

Please indicate in detail the amount requested from R. Howard Webster Foundation.

• *

  Specific details	Amount

Application attachments

Please upload all required documents (most recent financial statements, operating budget, annual report, list of your board of director and senior staff), as well as any other supporting documents.

NOTE: All documents should be in PDF format. We do not accept other file formats such as doc, xls, jpg.
IMPORTANT: Should the total sum of your files exceed 10 MB, please use this LINK to upload your attachments.

• Drop files here or Select files

  Accepted file types: pdf, Max. file size: 10 MB, Max. files: 7.