APPENDIX A

Aboriginal Relations GRANT APPLICATION

ECONOMIC CAPACITYBUILDING

This grant application is intended for applicants, applying for a grant through Aboriginal Relations (AR), to carry out a project/ initiative which is consistent with the mandate of AR. The following conditions apply:

A grant application must be completed, with the relevant documentation attached, and submitted to AR at the address below. Response to a grant application will be delayed if insufficient information is provided.

  • Any corporation or society requesting a grant must be currently registered, and provide proof of corporate status with grant application.
  • If a grant is made and a grant recipient does not use all the money for the purpose for which the grant was provided, the recipient shall refund the money to the Minister of Finance and Enterprise. However, if authorized by the Minister, the recipient may retain and use surplus money in accordance with conditions prescribed by the Minister.
  • The grant recipient shall retain all invoices and receipts in relation to an approved grant for two (2) years afterthe termination or conclusion of the grant term.
  • Upon completion of the project/initiative for which a grant was provided, the recipient will be required to provide a financial statement that lists all revenues and expenditures and may be required to submit a report summarizing and evaluating the project/initiative. AR may, at any time, conduct an evaluation of the project/initiative or conduct an audit of the recipient’s books, accounts and records related to the project/initiative.
  • The Minister may vary the original application for a grant and may establish further terms and conditions as a basis for providing a grant.
  • The grant applicant acknowledges that the information provided is subject to the Freedom of Information and Protection of Privacy Act.
  • The Minister, or the Minister’s representatives, may make or issue public statements regarding this grant.

If you require clarification or assistance in completing this application, please contact:

Manager, Economic CapacityBuilding

Aboriginal Relations

1301 Commerce Place, 10155 – 102 Street

Edmonton, Alberta T5J 4G8

Phone number: (780) 644-1057

Fax number: (780) 427-1760

A.Grant Applicant Information

Name of applicant (e.g. organization) Attach a list of current Board of Directors and their positions if applicable, and your organization’s mandate

Address / Phone number
Email Address / Postal Code / Fax number
If the organization is incorporated, indicate the following:
Provincially incorporated
Extra-provincially incorporated
Federally incorporated / Which Act(s) is the organization regulated by:
Societies Act
Companies Act
Other (explain) / If not incorporated, please check one of the following:
First Nation
Other (explain)

A.Grant Applicant Information (continued)

Purpose of organization or applicant’s role in project / initiative.

B.Project Information

Title of project / initiative / Start Date / End Date
Contact person / Phone number
  1. Briefly describe the project / initiative (including: activities planned, expected participants/target groups, etc.). Relevant documents must be attached.

  1. Describe the objectives of the project/initiative.

  1. Describe the community support for the project/initiative, including a list of other organizations involved. Attach relevant documents (e.g. Board motions, Band Council Resolutions, letters of support).

B.Project Information (Continued)

  1. Describe the direct benefits of the project/initiative to Albertans in your community and/or in Alberta.

  1. If funding is provided for a particular project/initiative, will the site be accessible to persons with disabilities?YesNo

C.Budget

1.List all revenues, including self-generated, in-kind donations and other GOA funding. Attach confirmation of funding from other sources. REVENUES

/ $
$
$
$
$
$
$
$
$
$
$
$
$
Total Revenues / $

2.List all expenses. Attach separate sheet if necessary. (Be as specific as possible).

EXPENSES
/ $
$
$
$
$
$
$
$
$
$
$
$
$
Total Expenses / $ $

C.Budget (Continued)

3.Which items in your budget do you plan to use AR funds for?
/
Amount of grant requested
$

D.Declaration

This application must be signed by an individual with full legal authority

(e.g. Chairperson, Chief, President)

  • I certify that the information presented in this application is accurate.
  • The project is endorsed by the organization which I represent.

Signature

/

Name (please print)

/

Date

ymd

Position Title

/

Phone Number

/ Fax Number

Page 1