Community Climate Grant - Lanark County

Required fields are marked with asterisks (*)

Please complete the form below to submit your Lanark County Community Climate Grant Application.

Project Contact Person/Organization

Contact Person

Title

Street Address

City/Town

Postal Code

Telephone

How long has the group been in existence?

Sponsoring Organization (if applicable)

Name of Organization

Street Address

City/Town

Postal Code

Telephone

How long has the sponsoring group been in existence?

Applicant Profile

Describe the mandate, mission, or general purpose of the group.

Outline your experience working in the project area. Give examples of successful projects you have participated in or completed in the past.

Project Overview

Name of Project

Briefly describe the proposed project, including project goals and objectives.

Outline the work plan and timeline of the project, including the main activities and how long each one will take.

Merit of Funding

Describe how the proposed project aligns with at least 1 of the 7 guiding principles of the Climate Action Plan. Select the Help Icon to review the guiding principles.

Describe how the proposed project provides a climate or environmental benefit to the County of Lanark.

List the partners to be involved in the project including their roles, responsibilities, and/or contributions to the project.

Project Budget

Provide a dollar amount and description for each applicable expenditure category below. Be specific about the expenditures (e.g., for salaries, list the positions and level of pay; for purchase of service, list the type of service and the cost; etc.). The Community Climate Grant will not fund 100% of the project budget. In kind donations (e.g., staff or volunteer time, existing equipment or office supplies, donated goods, etc.) count towards the project budget.

Salaries & Benefits (Amount)

Salaries & Benefits (Description)

Travel Expenses (Amount)

Travel Expenses (Description)

Printing/Postage/Office Supplies (Amount)

Printing/Postage/Office Supplies (Description)

Rent/Utilities/Phone (Amount)

Rent/Utilities/Phone (Description)

Advertising (Amount)

Advertising (Description)

Program Supplies (Amount)

Program Supplies (Description)

Purchase Services (Amount)

Purchase Services (Description)

Equipment Lease (Amount)

Equipment Lease (Description)

Other - Please Specify (Amount)

Other - Please Specify (Description)

Total Budget (Amount of all items above)

Less total funding requested/received from other contributors for this project (list below). This can include in-kind donations.

Amount requested from other sources (list the other sources and amounts requested)

Amount received from other sources (list the other sources and amounts received)

Total In-Kind Donations

Total funding request from Lanark County Community Climate Grants Program (total budget less any amount received from other sources and in-kind donations)

Note: The costs of your project must be kept separate from your group's everyday, ongoing expenses.

Please upload any additional material that is relevant to your application.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Authorization

By signing you declare that you are authorized to sign this application on behalf of the organization applying for a Lanark County Community Grant.

Clear

Name:

Position:

Date:

All required information must be submitted with proposals before consideration is given to projects.