ParaSport and Recreation PEI Membership Funding Application Membership Funding Application Step 1 of 4 25% SUBMISSION DEADLINE Applications will be accepted twice annually. For spring/summer requests, applications must be received by April 1. For Fall/Winter requests, applications must be received by October 1. Contact ParaSport office at (902) 368-4540 for the accessible version of this form. Printed application can be submitted by fax or mail. Mailing address: ParaSport and Recreation PEI 40 Enman Crescent, Room 123 Charlottetown, PEI C1E 1E6 Email: info@parasportpei.ca Fax: 902-368-4548 General InformationName of Applicant First Last Mailing Address Street Address Address Line 2 City ZIP Code Email Address Phone NumberAmount of funding requested: Project Start Date DD slash MM slash YYYY End Date MM slash DD slash YYYY Partner Contacts (If applicable)Name of Contact Organization Name Email Phone Project DescriptionWhat do you intend to use the ParaSport and Recreation PEI funding for? Please provide a detailed description and this is important to you.Additional Documents Drop files here or Select files Max. file size: 256 MB. BudgetPlease include below, a detailed breakdown of all revenue and all expenses associated with the project. To be eligible, costs must be directly related and necessary to the project. Be sure to include the amount requested. Please note that failure to disclose all sources of revenue will void the application and applicant will be ineligible to apply in the future.RevenueList all sources including out of pocket contributions, other grants and donations received.SourceAmount Add RemoveTotal RevenueList of ExpensesTravel (Include gas, tolls, accommodations, etc.)Amount Add RemoveEquipmentEquipmentAmount Add RemoveEquipmentOther (E.g. Registration fees, membership fees, etc.)Amount Add RemoveTotal ExpensesRevenue and Expenses Additional DocumentMax. file size: 256 MB.Total funding requested from ParaSport and Recreation PEI Membership Funding Program: DeclarationI confirm that the information contained in this application and any accompanying documents is accurate and complete to the best of my knowledge. I acknowledge that if this application is approved, I will be required to follow the terms and conditions of the grant.Signature of ApplicantDate Signed DD slash MM slash YYYY Name of authorized signatory (if applicant is under 18): Signature of authorizes signatory:Date Signed DD slash MM slash YYYY Δ
