Grant Application – Organizations

Organization

Canadian Registered Charity

Yes

No

Charitable license number

Street Address

City

Postal Code

Contact Person

Email

Title

Phone

Street Address

City

Postal Code

Chapter Sponsor (if applicable)

Brief history and description of organization:

Project title and brief description:

Geographic Area To Be Served

Client Group To Be Served

Anticipated Project Time Frame

Request Type

Special Project

Operating Support

Seed Money/Pilot Project

Total Project Cost

$

Amount of Matching Funds

$

Source of Matching Funds

Amount requested from Harmonize For Speech Fund

$

Date of this application

Date when funds are requested

Please answer each question in the space provided. Additional attachments other than the ones requested on Page 1 of this application are not necessary unless essential to the understanding of your programs. You are encouraged to submit with your application photographs and/or video of your organization.

NOTE: by submitting photographs and/or video, you are giving the Harmonize For Speech Fund consent to reproduce or reuse the materials for promotional or publicity purposes if your application is approved.

Objective/Purpose: What specific problem is to be solved? How will the objective be accomplished?

Approach: How and where will the program be implemented?

Support: What kind of local support is there for this program?

Competence: What evidence can you give of the ability of your organization and personnel to implement this program successfully?

Evaluation: How does the organization plan to evaluate the success of the program?

Relevance: Why should the Harmonize For Speech Fund support this program?

Harmonize For Speech Funds: How will the funds be used?

Future Funds: How will the project be financed in the future?

Additional Comments:

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Organization Application