NOTES TO APPLICANTS:

PLEASE REFER TO THE NEEDS ASSESSMENT AND PLANNING GRANT BROCHURE FOR FUNDING
GUIDELINES ANO CRITERIA BEFORE DEVELOPING YOUR PROPOSAL.

Please submit the following documentation with your application:

A detailed project proposal for each grant request (CCNA and/or CCP) which;
* identifies the geographic area to be covered;
¢ describes the process that will be undertaken to achieve the goals of the project;
* includes a detailed project budget (example follows);
«includes a copy of the local government resolution supporting the application and a letter
confirming the commitment of focal government resources,
° describes the process to Inciude input from a broad range of interests.

If the applicant is a society this additional documentation is required:

* a copy of the Society's Annual Financial Statement from the year immediately preceding the
date of application which Includes, at minimum, a Balance Sheet and a Statement of Revenue
and expenditure and a recent monthly financial statement; ;

°a list of the Board of Directors identifying those who are Executive Officers by position.

CERTIFICATION:
| hereby certify that to the best of my knowledge all information contained in this application is true and complete.

The organization | represent is willing to enter into an agreement for financial assistance with the Ministry of
Women's Equality if this grant application is approved.

NAME: Russ Hellard DATE: 93.11.12

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POSITION: Board member SIGNATURE: N L, c

Submit your application to: Ministry ot Women's Equality
Child Care Branch
2nd Floor, 756 Fort Street
Victoria, B.C. V8V 1X4
Phone: 356-7960
Fax: 953-3327

OFFICIAL USE: FILE NO:

Date received: Reviewed by:

Approved by: Amount approved: $

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