2. Note: The deadline for cash/in kind grant applications is February 28 in the year in which the grant is required and July 31 of the previous year for property tax exemptions.

   The information collected in this application is governed by the provisions of the Freedom of Information and Protection of Privacy Act and will be used solely for the purposes of assessing grant claims. For more information on the provisions of the Act and the protection of your personal information please contact City Hall at 250-837-2161.
4. Name of individual or organization*
6. Address:*
8. Telephone:*
10. Fax:
12. Email:
14. Type of assistance required: (Please note: Property tax exemptions are governed by the Local Government Act and are limited to certain types of use and organizations)*

    1. Cash
    2. In kind benefit
    3. Property tax benefit
16. If in kind benefit, please indicate type (e.g. free rental of facility)
18. Amount of grant being requested: *
20. Purpose for which grant is being requested:*
22. Please indicate the implications for you or your organization if this grant is not approved:
24. Please list below other organizations/individuals you have approached for funding and the amount expected from each:
26. Name
27. Amount:
29. Name
30. Amount:
32. Name
33. Amount:
35. Name
36. Amount:
38. Name
39. Amount:
41. Name
42. Amount:
44. If you are applying for a property tax exemption, please provide the address and legal description of the property:

46. Declaration:
    I have read the City's Grant-in-Aid Policy and understand the terms and conditions. The information contained in this application, together with any attached information is a true and fair view of the state of the organization's/my finances.

    I am attaching herewith a copy of the latest financial statements of the organization and/or a budget.

    I understand that by making an application it does not of itself guarantee funding and that the City may ask for additional information in order to determine eligibility.

48. Name:
50. Date:
52. Attachment:
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field