Grant Application - Community Power Northumberland

Applicant Information

Name of Community Organisation / Project *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Website / URL (if applicable)

Contact Person Name *

Contact Title (if applicable)

Contact Email *

Contact Phone Number *

Please choose the type of organisation/project that best applies: *

Please provide your non-profit incorporation # or charity registration # (if applicable)

For charities and registered non-profits - please indicate the number of Board Members and Members:

Provide a brief overview of organization or business (max 50 words)

Project Information

Project Name *

Period Grant Would Cover:

One Year
Two Years
Three Years

What is the proposed START DATE and END DATE for the proposed grant? *

Grant Amount Requested ($) *

Please indicate the total grant amount for all years if applying for a multi-year grant.
You will provide a detailed budget for Year 1 below and will be expected to submit detailed budget breakdowns for subsequent years towards the end of the first year of implementation.

What is the project (max 25 words)? *

Provide a brief description of your project (max 200 words): *

Describe how your project aligns with CPN's Mission, Vision, and Goals (max 200 words): *

Provide a breakdown how the grant will be allocated in your budget (follow the guidance below) *

1. Please provide clear and detailed budget lines and amounts for each planned expense.
2. For multi-year projects, please provide the detailed budget for Year 1 only. You will submit detailed budget for year 2 towards the end of your first year of implementation as part of your reporting requirements.

Sample Budget
Event Permit - $100
Printing Signage - $200
Craft Supplies - $200
Sound Equipment Rental - $300
Total Budget OR Total Year 1 Budget = $800

Describe how you will monitor and evaluate the impact (community benefit) of your project (max 200 words): *

Identify any risks that might affect the project and any risk mitigation measures (max 200 words): *

Please provide any additional information that will help us to understand and evaluate your grant request:

Phone