Application for Community Grants. To be submitted by Jan 31 in the year for which the funds are requested. Name of Organization * Full Mailing Address * Contact Person * Email * Phone * Website Amount of financial assistance being requested (maximum request per budget year $3000) * Please provide details of the organization or project’s anticipated use of grant proceeds (if successful). Include the impact the organization/project has on the Town of Erin and its residents, and the importance to the Town * How will the funds be used? * Outline the mission, purpose and objectives of your organization * Does your organization receive funding from any other government source? * Yes No If you answered yes to the above question, please choose level of government. Federal Government Provincial Government County If your organization received financial support from the Town of Erin in either of the last 2 years, please indicate the amount of previous grants, and describe the use of the grant. * How long has your organization been in operation? Annual Meeting Date Officers for current year: President (please provide name, address and telephone number * Officers for current year: Secretary (please provide name, address and telephone number) * Officers for current year: Treasurer (please provide name, address and telephone number) * If there are any other comments that you would like to include that may assist Council when considering this application, please provide details here (or feel free to attach a separate document, if necessary): Additional supporting document Personal information, as defined in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected under the authority of the Municipal Act, 2001 and will be used in accordance with MFIPPA. The information will be used to determine eligibility for Community Grant funding. Questions about this collection of personal information should be directed to the Clerk's Office, 5684 Trafalgar Road, Hillsburgh, ON N0B 1Z0, Telephone 519.855.4407 EXT. 248, or Clerks@erin.ca. * Consent for storing submitted data * Yes, I give permission to store and process my data No, I don't consent to storing and processing my data
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