Funding request form for Community Organizations

Requesting organization *

Mailing address *

Resource person, title and fonction *

Telephone (home) *

Telephone (work)

Fax

Email *

Is your organization incorporated as a registered non-profit corporation? *

Yes

Has your organization previously received financial assistance from the Village de Memramcook? *

Yes

If yes, please elaborate

Is your organization a local organization or is it part of a regional, provincial or national organization *

What are the general objectives and functions of your organization and how do they fit into the general interest of the community *

What are your current sources of funding and what amounts are you receiving? *

What type of support are you requesting from the Village de Memramcook? (Check the appropriate category) *

Financing

Installations

Services

Amount requested *

What will the funding obtained be used for? *

If the Village de Memramcook allocates a donation or sponsorship, I acknowledge that our organization will respect the terms established by the village.

Required Documents

EACH REQUEST MUST BE ACCOMPANIED BY THE FOLLOWING (SEND BY EMAIL TO This email address is being protected from spambots. You need JavaScript enabled to view it. OR BY MAIL TO 540 CENTRALE STREET, MEMRAMCOOK, E4K3S6) : financial statements (preferably audited) for the previous financial year, the forecast for the operating budget for the next fiscal year and the list of the organization’s committee members.

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