All applications must be received by 11:59pm March 31st, 2019. No late submissions will be accepted. IMPORTANT Please note this form can not be saved and accessed at a later date, you may download and complete a sample form in advance of the online form here. Ensure you have the items listed below and a half hour before beginning the online application. After completion of the application we ask that you print a copy of this page for your records. Before beginning please have the following information on hand: Registered Charity or Not for Profit Organization number Dollar amount of funding request No more than 500 word description of the project Project commencement and completion date Total dollar amount of the capital project If the project will receive government funding please know the amount and any pertinent details List of confirmed donors and donation amount Short and long term public recognition opportunities for donors A PDF of the organizations most recent audited financial statements OR external review Questions About the Application? If you have any questions before beginning the application please contact us at email@example.com. Responses will be provided from Monday – Friday between 8:00am & 5:00pm, within 24 hours. Online Application Form Organization Information Organization Name * Registered Charity Are you a registered charity or not-for-profit? * Yes No If yes please provide the registration number. Street Address * City * Province * - Select Province -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code * Business Phone Number * Applicant Information Name of the most senior officer i.e President, CEO that has signing authority for your organization. * Name of the person submitting the application for the organization, if different than above. Phone Number & Extension * Cell Phone Number Email Address * Website * Project Information What county is your organization/project located in? * - Select County -OxfordElginMiddlesexHuronPerthChatham/KentLambtonGreyBruceEssex Nature of Applicant's Business: * Have you ever applied for support through either the Community Enhancement Fund or the Regional Enhancement Fund program? * Yes No If yes, when, and how much did you receive and for what type of project? Donations are intended for capital projects that are non-recurring within a 5-year period. Organizations that have received funding from the REFCD, in two (2) consecutive years are not eligible to re-apply within a 5-year period from the year they last received support. Funding Request Provide the dollar amount of the current funding request: * $ The request may include HST. Please upload a detailed budget of the capital project/items(s). * Files must be less than 2 MB.Allowed file types: jpg jpeg pdf doc docx. Please be sure to select your file and click the blue UPLOAD button on this page once the document has been added. Summary Description * (In no more than 500 words please describe the capital project, the rationale for the purchase and how it meets the WFD's broad objective as noted in the Funding Criteria) When will the project commence or purchase be made? * Year Year20192020202120222023202420252026202720282029 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 What date will the project be completed? * Year Year20192020202120222023202420252026202720282029 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 What is the total dollar amount of the capital project/purchase? * $ Will the capital project receive government funding? * Yes No If yes, please provide details. Include the confirmed amount being received. Please provide a list of confirmed donors, excluding those listed above. Include the confirmed amount being received. What are the short and long-term public recognition opportunities for donors of the project? * NOTE: The REFDC and approved applicant will work towards a mutually agreed upon recognition plan. Document Uploads Please upload a copy of the organizations most recent audited financial statements, OR external review are required. * Files must be less than 2 MB.Allowed file types: jpg jpeg pdf doc docx xls xlsx. Please provide two (2) quotes/estimates for the purchase of the capital item with this application. Quote 1 * Files must be less than 2 MB.Allowed file types: jpg jpeg pdf doc docx odt. Quote 2 * Files must be less than 2 MB.Allowed file types: jpg jpeg pdf doc docx odt. Please be sure to select your file and click the blue UPLOAD button on this page once the document has been added. I certify that all of the information provided in this funding application is true and complete to the best of my knowledge. I understand that any false or incomplete information may disqualify this organization from further consideration for funding and may result in the REFDC’s request for refund of all financial support if false information is discovered at a later date. I have read, understand and agree to the above statement and I have authority to bind this organization. * I Agree If your application is approved by the REFDC for consideration, please be prepared to make a presentation, if requested. Incomplete applications will not be considered.