Provincial Grant System This form should be used when applying for any Special Olympics Ontario Provincial Grant. Please complete the relevant sections of this form in their entirety.
A. GENERAL INFORMATION Please complete general information pertaining to the applying party and the nature of the application.
Sport Club / Program or Competition Name
District* Central Ontario Eastern Ontairo Greater Toronto Area North East North West South Central South West
Community* Barrie Central Bruce Collingwood & Area Dufferin Haliburton Huntsville Huronia Kawartha Lakes Kincardine & Area Meaford - Thornbury Muskoka Orillia Owen Sound & Area Peterborough South Saugeen South Simcoe Wingham & Lucknow
Community* Arnprior Belleville - Quinte West Brockville and Area Kingston Lennox & Addington Northumberland Ottawa Pembroke Perth Renfrew Smiths Falls
Community* Aurora Brampton Caledon Greater Durham Mississauga Newmarket & Area Toronto Vaughan York South
Community* Almaguin Highlands Azilda Elliot Lake Espanola Iroquois Falls Hearst Kapuskasing Manitoulin Island New Liskeard North Bay Parry Sound Sault Ste. Marie Sudbury Sudbury East Timmins Valley East West Nipissing
Community* Atikokan Dryden Fort Frances Kenora Marathon Red Lake Terrace Bay Thunder Bay
Community* Burlington Cambridge Dundas Fort Erie Guelph Haldimand County Halton Hills Hamilton Kitchener-Waterloo Milton New Hamburg North Wellington Oakville Port Colborne St. Catharines Welland - Pelham West Niagara
Community* Brantford Chatham-Kent Goderich I.C.H.A Ingersoll LaSalle - Windsor Leamington/Essex London Sarnia Simcoe St. Thomas Stratford and Area Tillsonburg Woodstock Woolwich (Elmira)
Sport Alpine Skiing           Athletics             Basketball            Bocce                Bowling – Ten Pin       Bowling – 5 Pin        Cross Country Skiing     Curling               Figure Skating         Floor Hockey          Golf                 Powerlifting           Rhythmic Gymnastics   Snowshoeing          Soccer               Softball               Speed Skating          Swimming             Multiple Sports Other
Please select the sport or sport group that this grant will support.
Club or Program Type
Is this program or competition already registered with Special Olympics Ontario? Grant Type:* Select the type of grant you are applying for.
B. CONTACT INFORMATION Key contact information for club, community or partner applying for this grant.
Name
Mr. Mrs. Miss Ms. Dr. Prof. Rev.
Prefix
First
Last
Suffix
This is generally the individual who is completing the grant request.
Phone
Email* Position / Title / Role Community Coordinator Secretary Treasurer Head Coach Team Manager Athlete Volunteer Facility / Program Staff Educator Event Organizer Fundraiser Public Relations Community Council Member Regional Coordinator Regional Committee Member SOO Partner Other
The role of the main contact with relation to this program , initiative or event.
If applicable, is your local Community Council / Regional Council or Special Olympics Ontario aware of this grant application and do they endorse this request for funds? If No or Not Applicable please provide rationale for the lack of community endorsement.
It is important that all grant applications submitted to Special Olympics Ontario are done with the knowledge of the community in which they exist. In some circumstances this may not be applicable or possible. A short explanation explaining this circumstance will speed up the approval process.
Community Contact Name
First
Last
If you answered YES to the question above, please provide the contact in the community, either treasurer or community coordinator. If the person filling out the form is the same person, please fill in their name and leave the additional contact fields blank.
Community Contact Phone #
Community Contact e-mail Position / Title / Role Community Coordinator Secretary Treasurer Head Coach Team Manager Athlete Volunteer Facility / Program Staff Educator Event Organizer Fundraiser Public Relations Community Council Member Regional Coordinator Regional Committee Member SOO Partner Other
The role of the main contact with relation to this program , initiative or event.
C. PROGRAM / PROJECT PROPOSAL In this section, please provide an outline of the proposal and goals of your project or program. Formal proposal plans and supporting documents can be uploaded in the fields at the end of this section.
Project Description / Outline
In this section, please provide a brief description/outline of the proposal and goals of your project or program. Formal proposal plans and supporting documents should be uploaded in the fields at the end of this section.
Please indicate which Special Olympics Ontario Strategic priority this proposal will address? (Check all that apply) In this section, please provide a brief description/outline of the proposal and goals of your project or program. Formal proposal plans and supporting documents should be uploaded in the fields at the end of this section.
Please indicate how this grant will benefit your community, athletes or volunteers? (Check all that apply) In this section, please provide a brief description/outline of the proposal and goals of your project or program. Formal proposal plans and supporting documents should be uploaded in the fields at the end of this section.
Number of Athletes currently involved in this program. In this section, please provide an outline of the proposal and goals of your project or program. Formal proposal plans and supporting documents can be uploaded in the fields at the end of this section.
Proposal Document A formal proposal document outlining this program, project or event please feel free to attach it here. Additional spaces for budget and supporting documentation are available further on in this form.
Supporting Document If you have a supporting document for this proposal feel free to include this here (not required).
D. FINANCIAL REQUEST & BUDGET This section serves to outline the nature of your funding request. The numbers listed in this section should serve as approximate projections of expenditures and income.
Expenses
Please indicate approximate projected expenses for this grant application according to the headings below. Additional information can be included in the budgetary notes at the end of this section.
Accommodations
Please indicate the approximate budgeted amount for accommodations.
Equipment
Please indicate the approximate budgeted amount for equipment (not disposable)
Facilities
Please indicate the approximate budgeted amount for facilities and venues.
Food
Please indicate the approximate budgeted amount for Food.
Please note that the SOO Grant program will not generally offset the cost of food in a grant proposal.
Materials & Supplies
Please indicate the approximate budgeted amount for consumable materials
Publicity & Media
Please indicate the approximate budgeted amount for Publicity and Media
Transportation
Please indicate the approximate budgeted amount for travel and transportation
Uniforms
Please indicate the approximate budgeted amount for uniforms.
Athlete Training & Development
Please indicate the approximate budgeted amount for athlete development.
Volunteer Training & Development
Please indicate the approximate budgeted amount for volunteer development.
Other Expenses
Please indicate the approximate budgeted amount for other or additional costs. Please describe these additional costs in the notes below.
Expense Notes
Please include any additional explanations about the expense numbers quoted above. Detailed breakdowns can also be included in the attached budget.
Income
Please indicate approximate or projected income sources over and above money's requested through this grant for your club season or event. You can expand on any information here in the Income notes field below.
Is the community or club providing any funding for this program or initiative? Amount of SOO Community Council Funding
Please indicate the approximate or projected amount of funding expected from your local SOO Community Council.
Registration / User Fees
Please indicate the approximate projected income expected from registration or user fees.
Fundraising
Please indicate the approximate projected income expected from fundraising initiatives and activities.
Sponsorship & Donations
Please indicate the approximate projected income expected from sponsorships and donations?
In-Kind Support (Gifts, Services & Facilities)
Please indicate the approximate projected value of in-kind support (Gifts, Services & Facilities)
Product or Promotional Material Sales
Please indicate the approximate projected value of grants from sales.
Other
Please indicate the approximate projected income expected from other revenue sources. (Not including External Grants)
External Grants or Funding Sources
Please indicate the approximate projected value of grants from other sources / agencies. (Please outline the additional funding sources in the income notes field below.)
External Grant Description
If you have applied for or received funding from an external grant source (such as the Trillium Foundation or local municpality) please list your external funding source and File # (where available)
Income Notes
Please include any additional explanations about the income numbers quoted above. Detailed breakdowns can also be included in the attached budget.
Budget Summary
In this section please attach a detailed budget for this project/grant as well as supporting community financial statements or budget and any additional financial information relating to this application.
Total Grant Funding Requested
What is the total amount of funding you are requesting from the Special Olympics Ontario Grant Program?
Grant Budget* Please attach a detailed budget for this program, project, event or initiative. This budget can be provided in any document format and should include a detailed breakdown of approximate expected costs.
Community Budget / Community Treasurer'Report* If this request is being made on behalf of a community or a program or project within a community, please attach a community budget or treasurer's report from your community treasurer.
Supporting Budget Document 1 If you have any additional budgetary document please feel free to upload them in this space. This could include the club budget if you are applying for development funds for an existing club.
Supporting Budget Document 2 If you have any additional budgetary document please feel free to upload them in this space. This could include the club budget if you are applying for development funds for an existing club.
E. BANK ACCOUNT TRANSFER INFORMATION In order to receive any funds from SOO, your community and/or club must have a Royal Bank account under the SOO Centralized Banking System. (Bank Transit # 06702).
Do you currently have a bank account that is part of the SOO Centralized Banking System (Transit # 06702) If you currently do not have a bank account under the SOO Centralized Banking system you will be required to contact your District Developer or the SOO Finance Department.
Account #
If available please indicate your bank account number here.
Treasurer or Signing Officer
First
Last
Please provide the name of your accounts treasurer or one of your signing officers here.
Treasurer or Signing Officer e-mail
Please provide the e-mail address of your treasurer or signing officer here. This is to ensure that they are notified when the transfer of funds has taken place.
F. IMPACTS & OUTCOMES Please complete general information pertaining to the applying party and the nature of the application.
Number of Athletes affected by this Grant
Number of Volunteers (including Coaches)
Number of Trained Coaches
Number of Spectators / Fans / Community Members
Will this program / project result in New Volunteers? Will this program / project make use of one time event volunteers? Approximate number of Event Volunteers?
Will this program result in new athletes? Approximate number of potential new athletes
Anticipated Media or Public Awareness Exposure? (Please elaborate in the additional impacts field below) Indicate expected type of Public Awareness exposure (check all that apply) Additional Impacts
Please include any additional explanations about the numbers quoted above here. If you have any additional
Do you expect the program / initiatives / project resulting from this grant to continue once your grant ends? If yes, how will this happen? Check all that apply. If no, please indicate why the project or initiative will not continue. Check all that apply. Outcome Notes
Thank you for taking the time to complete this application.
This concludes the main component of your application. Please review the application before submission and ensure that you have read and signed the release below by typing your name in the allotted box. Upon submission you will have the opportunity to review your grant application. A copy of the grant application will be sent to you and to the SOO Grant Committee.
G. RELEASE * I understand that the information contained in this application is subject to review and approval by the Special Olympics Ontario Grant Review Panel. I agree to abide by the decisions of the panel as they pertain to this grant and acknowledge that clarification of all or part of this proposal may be requested at any time.
Type your name here to verify your understanding of the above statements*
