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Helen McCrea Peacock Foundation:2018 Grant Application Form

Deadline: Monday, April 30, 2018

Cover Sheet –Organization Contact Information
Name of Organization
Charitable Registration Number
Address of Organization
2018 Operating Budget for Organization
Name of Program requesting funds for
Amount Requested
Total Budget of Program requesting funds for
Contact Name and Title
Email Address of Contact
Phone Number of Contact
Organization Website
If you have a charitable trustee, please fill out the fields below:
Charitable partner name and address
Charitable partner charitable registration number
Charitable partner contact name, email and phone number

Application Authorization:

Name, Title: ______

(Application must be approved by an organizational representative with authority to legally bind the organization.)

Signature: ______Date: ______

(Electronic signature is acceptable)

Which of the following priorities does your program address? (check one)

[ ] Land
- conservation and protection
- tree planting and stewardship
- naturalization and restoration / [ ] Watershed
- land and shore restoration
- conservation, protection and naturalization / [ ] Wildlife
- biodiversity
- wildlife rehabilitation and protection

If you have been invited to complete this 2018 application by a Helen McCrea Peacock Foundation Board Member, please indicate the name of the Board Member here:

About the Applying Organization

  1. About the organization (Limit: 100 words)

About the Program

  1. Describe the program or project you are requesting funds for, including objectives and outcomes, and provide any relevant statistics(Limit: 100 words)

the grant request

  1. Amount requested and activities the grant will support - Provide a brief budget for the grant request: break down each activity by line item with a short description of each (Limit: 300 words)
  1. Grant impact statement - Provide a one-sentence description about the potential impact of a grant from the Helen McCrea Peacock Foundation(Limit: 20 words)

Attachments:

Trusteeship agreement (if you are applying though a charitable trustee): include a PDF of the agreement, dated and signed by both parties, outlining the nature and duration of the relationship

______

Please submit this form by e-mail as a Word document (not PDF)c/o Toronto Foundation to:

Torey Kehoe, Fundholder Engagement Officer

T: 416-921-2035 ext. 230

E: