Community Grants Application

Home
About Us
Grants Program
Other Coalitions
Contact Us

Home
About Us
Grants Program
Other Coalitions
Contact Us

The Budget Example (below) is a sample of the detailed information needed from you, as part of the Community Grants Application. Please complete the online form below. Successful applicants must allow approximately 6 weeks for review of application and the receiving of funds.

Online Community Grant Application Form

Name of Organization/Group:

Organization/Group Description:

Contact Person

Co-Applicant

Street Address (Line 1)

Street Address (Line 2)

Town & Postal Code

Email Address

Telephone Number

PROJECT DESCRIPTION:

Project Name

Start Date

End Date

Project Summary

Wellness Areas Chosen (Please check ALL that apply):

Healthy Eating Child & Youth Development Physical Activity Health Protection Tobacco Control Mental Health Promotion Injury Prevention Environmental Health

Target Group: Who is the project intended for?

Participants: How many might take part?

Goals: What do you plan to do?

Activities: How will you do it?

Project partners:

What are these partners doing to help with this project?

How will this project benefit your community?

What else would you like us to know about this project?

PROJECT BUDGET

Funds requested from: (Choose One Below)

Northern Regional Wellness Coalition Other Source

Funds requested from: (Choose One)

Northern Regional Wellness Coalition Other Source

How will you recognize the contributions of the coalition? (Posters, Newsletters, etc.)

AUTHORIZATION
Do we have your permission to share information?

Do we have your permission to use any photos sent in?

I agree that the Northern Wellness Coalition has full use of information and/or photos of my event to promote healthy living in any future publication.

Successful applicants must allow approximately 6 weeks for review of application and the receiving of funds.

Phone: (709) 454-0522 / 454-0346

178-200 West Street, St. Anthony, NL A0K 4S0

Community Grants Application

Online Community Grant Application Form

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