Date Received at Pgnaeta
2012/2013 URBAN ABORIGINAL FUNDING APPLICATION
Sponsor:Mailing Address:
Telephone:
Fax:
E-mail:
Contact Person:
Title:
Date:
Authorized Signature:
WCB #: / WCB Rate %:
C.C.R.A. #: / PCTIA Registration #:
All Urban Aboriginal Businesses must include the following:
- A copy of the organization’s current year Certificate of Incorporation.
- A signed original Board Motion that demonstrates support for the project.
FOR OFFICE USE ONLY: DATE RECEIVED
FILE #______
Please provide a brief History/background of your agency, the agency mandate, the organizational structure and a brief summary of previous experience in program delivery.
Please indicate under which program option you are applying for funding?
Aboriginal Skills Development (ASD)Employment Assistance Program (EAS)
Aboriginal Youth InitiativesProject Based Training (PBT) Summer Careers Placement (SCP) Delivery Assistance (DA)
Aboriginal Comm. Enhancement (ACE)Labour Market Partnerships (LMP)
Youth Empowerment Strategy (YES)Targeted Wage Subsidies
Community Based Development (CBD)
Title of Project.
1) Please describe this project.
2) What is the overall objective of this project/service?
3) What are the sub-objectives of this project/service?
4) What needs, issues, barriers or challenges will be addressed?
5) Has this training/Service been provided previously? If yes, what were the results?
6) Who will this project/service be targeting?
Unemployed Under-Employed Self-Employed Employed
Male Female Youth (15-29)Disabled
7) What is the anticipated total number of participants?
8) How will participants will be recruited and selected?
9) How will participant progress be evaluated, explain the process?
10) How will the mandatory twelve (12) week follow-up be carried out once the project is completed?
11) What is the start and end dates of the project/service?
12) If this project/service has more than one intake, what are the start and end dates of each intake?
13) Employment results, or increase in skills and industry driven are two main objectives for Urban/Rural Funding. How does this project demonstrate these outcomes?
14) Where will the activities take place (Urban or rural)?
15) Please list Project Staff, Training Institute or Service Representative if they have been identified?
16) If identified, is their résumé attached?Yes No
17) Describe the program activities, training plan and provide a course outline.
18) What certificates or accreditation will be provided upon completion of program?
19) What are the measurable outcomes and milestones of this project?
20) How will the content of the project or level of service be evaluated?
21) What are the plans to sustain this project after the end date, do you have an exit strategy
in place?
22) How will Instructors, Facilitators or Service Representatives be evaluated?
23) What process will be in place to ensure reports and financial claims are submitted in a timely manner?
24) Has this proposal been submitted to funding sources other than the UAWG? Yes No
25) If yes, when will a response be provided?
26) If no, why not?
27) Will this link to funding/in-kind contributions from other departments? Yes No
28) If yes, is a written commitment in place? Yes No
29) Recommendations for funding will be contingent upon established partnerships. Please demonstrate any partnerships that have been established for the program or service being offered?
30) Will the partnership include funding/in-kind contributions from the partner? Yes No
31) If yes, provide a letter of commitment from your partner(s)? Yes No
32) Is this project/service supported and endorsed in form of a Board Motion? Yes No
33) What is the proposed budget? Please list details of wages, overhead costs, participant costs, training costs and monetary or in-kind contribution received from other partners or departments.
34) Describe unique, innovative or progressive features of your proposal.
2012/2013 Version1