FRASER RIVER PORT MILLENNIUM FUND
GRANT APPLICATION FUND

  Fraser River Port MILLENNIUM FUND FILE #____________

APPLICATION SUMMARY
a) Project title
b) Project description
c) Amount requested from Fraser River Port Millennium Fund
d) Total project budget

SECTION A - GENERAL INFORMATION REGARDING APPLICANT ORGANIZATION
1. Name of Organization

2. Contact Person

3. Address



City/Town

Province

 Postal Code
Telephone No. (       )
Fax No. (       )

Email
Website
4. Charitable Registration No.

5. Registered Business No.

6. B.C. Society Act Registration No. (if applicable)

7.(a) Board of Directors                                                                           List attached 

         Name of Chairperson/President   _________________________

         Telephone No. (     )__________________   Fax No. (     )__________________
EXISTING ORGANIZATIONS AND PROJECTS, PLEASE SUPPLY THE FOLLOWING INFORMATION
8. (a) Financial Year from ___________________________ to ________________________
                                                        (month/day)                                         (month/day)
    (b) Financial statement for last complete year    attached
    (c) Operating budget for current year     attached
    (d) Most recent comparative financial report     attached
    (e) Project budget     attached
Is this project incorporated into the operating budget for the year?      Yes        No   
Annual Report     attached
SECTION B - INFORMATION ON PROJECT FOR WHICH FUNDING IS REQUESTED
9. Briefly describe proposed project, its goals and objectives, proposed plan of action



10. Briefly describe who would benefit from the Project



11. Duration:      From ____________________ to ____________________
                                            (yyyy/mm/dd)                          (yyyy/mm/dd)
12. Project Budget Summary

EXPENDITURES

Salaries\benefits
 $
Rent\utilities\telephone
$
Capital costs (specify)
$
Other (specify)
 $
Total Expenditures
$
REVENUE
Projected Revenue Sources
(please not any revenues eligible for matching funds)

Confirmed

Potential

Total
Cash      
Government sources      
Donations      
Foundations      
Other

      
Fraser River Port Millennium Fund      
Total Revenue $ $ $
13. Date(s) funds required



14. Description of community involvement and collaboration with other agencies



15. How do you plan to evaluate the success of the project?



      16. Signatures for Applicant Organization

      We certify that this application for funds has official approval from the organization's Board of Directors

      Senior staff person _________________________ Date _______________

      Chairperson/Board Representative _________________________ Date _______________


FRASER RIVER PORT MILLENNIUM FUND
500-713 Columbia Street
New Westminster, BC V3M 1B2
Phone: (604) 524-6655 Fax: (604) 524-1127