Application - Municipality of the District of Shelburne

Please download the Grants Policy. It contains important information related to the application form.

Name of Applicant Organization

Please type your organization.

Contact Person(*)

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Mailing Address(*)

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City / Town(*)

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Postal Code(*)

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Telephone(*)

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E-mail Address(*)

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NS Registry of Joint Stock Number(*)

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Federal Charitable Status Number(*)

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If you do not have either of the above numbers, provide the name and contact information of the organization that you are affiliated with

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Please indicate the amount of the grant where applicable.

Capital Grant

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Operating Grant

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Have you applied for other funding for this project/program/service? Please list the Funding Body, Requested Amount and Confirmed Amount. Please indicate each source of funding on a separate line.

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Please describe your organization's specific project, program or service.

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Please describe the community, area and/or group(s) your organization serves.

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What benefits will your project, program or service provide to the community/municipality?

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Please summarize the major elements of the budget of your project or organization’s operating budget and attach a copy of the financial statement for your organization or project.

We accept .doc, .docx, xls, xlsx, .pdf file formats up to 4MB in size. Please be sure not to have any empty spaces in the name of the uploaded file.

Upload Financial Statement or Treasurer's Report

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Upload Financial Statement or Treasurer's Report

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Budget

Revenue

Organization $ Contribution

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Fundraising

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Donations

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In Kind (If applicable)

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Other Grants

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Loan

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MDS Grant Request

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Total Estimated Revenue

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Expenditure

Please note Details and $ Amount on each line.

Expenditure Details

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Total Estimated Expenditures

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Please include Name, Position, Address and Telephone information of all Directors separated by a line.

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Please ensure your submission includes the following

Proof of current registration as a non-profit or charitable organization or affiliate organization; Most recent financial statement; Your organization's budget for the upcoming year or project; Final report (if received funding in the last fiscal year) Invalid Input

Remember the Deadline for Applications is January 31^stor the last working day of the month of January to be considered for funding in the upcoming fiscal year.

The information provided is true and honest.(*)

Confirm

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Security(*)

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Grants Program Application

Budget

Revenue

Expenditure