Step 1 of 7 14% Welcome to our grant application form. Mandatory fields are indicated with an asterisk (*). Note you can move forwards and backwards within the seven steps without losing information. If you have to leave the form and come back, your information will not be saved, and you will have to start again. For additional information about completing this form, please reference the grant application guide.Dollar Amount of Grant Request*Application Deadline*September 1December 1March 1June 1Region*Vancouver IslandLower MainlandInteriorNorthern Contact InformationLegal Organization Name* Street Address* City/Municipality* Postal Code* Primary Contact PersonName* Position/Job Title* Email* Phone Number*FaxAlternate Contact PersonName Position/Job Title Email Phone NumberFax Eligibility RequirementsNon-profit Society*Is your organization a registered non-profit society? Yes No If yes to non-profit, date of registration If yes to non-profit, date of registration IncorporationIs your organization incorporated? Yes No If yes to incorporated, date of incorporation If yes to incorporated, incorporation number Fund Administration* Our organization will accept and distribute funds according to the project as approved and accept responsibility that all obligations and conditions relating to the grant are met. Project InformationProject Title* Project Start Date* Project End Date* Location(s) of Project Activities (communities, facilities) Executive Summary of Project*Provide a brief summary of the project that may be used as a project description for our grant adjudication and communication purposes. (Max 500 words)Project Objectives*Briefly describe the community and the issue your project is designed to address. If the project has been offered before, briefly describe the results and any changes that have been made to the project to improve outcomes for participants. Project ParticipantsDescribe who will participate in and/or benefit from the project. Audience AgeSelect the age of the audience who will benefit from your project. (Select all that apply Children 0 to 12 years Teens and Youths 12 to 25 years Adults 25 to 55 years Older Adults 55 years and over People of all ages Target Audience*Which of the following audiences will be included in the project? (Select any/all that apply) Homeless Seniors People with a life-limiting illness Those near end-of-life Caregivers Grieving family members/friends Culturally diverse individuals Newcomers Members of LGBTQ2 First Nations people Children and/or young adults Other Project Key Partner/StakeholdersPlease indicate any partners or stakeholders that will be involved with this project.Project Categories/Themes*Indicate the primary or major types of activities that will occur to carry out the project and the anticipated start and end dates. Palliative support Companionship Vigil support Spiritual support Complementary therapies Practical support Grief support Community education Professional education Caregiver support Respite care Project Categories/Themes - Other #1 Project Categories/Themes - Other #2 Project Categories/Themes - Other #3 Project Categories/Themes - Other #4 Activities and TimelineList each activity that will be undertaken to achieve the project objectives. Next to the activity, identify the month during which it will take place. Expected ResultsNumber of PeopleEstimate the number of people that will participate and/or benefit from the project.Outcomes*Describe the expected outcomes, benefits, or results that participants will gain from their involvement in the project. MetricsHow will you measure and evaluate the overall success of your project? How will you evaluate the results experienced by participants? Recognition of the Sovereign Order of St. John (SOSJ)*If a grant is awarded, describe how you will recognize SOSJ. Budget InformationTo assist with your submission, please download our Budget Information Excel template here. This document includes a tab for Revenue Sources, Expenses, and if applicable, In-kind and Other Contributions. Enter your information on each of the sheets, save the document with your organization’s name and the date, then please upload the document below. File Upload*Use the template provided above to provide estimated revenues, expenses and in-kind contributions that will support the project, and upload your file here.Max. file size: 128 MB.VolunteersWill volunteers be involved in planning and/or delivery of the project? Yes No If yes, indicate the approximate number of volunteer hoursProvide a brief description of how volunteers will be involved in the projectFinancial Statements*Please attach last year’s audited or reviewed financial statements (e.g., Excel, pdf, Word).Max. file size: 128 MB. Applicant Declaration To complete your application, you must confirm that you understand and agree with all of the following statements.Eligibility* I have carefully read and understand the eligibility criteria for this program as described in the application guidelines, and I confirm that the organization I represent meets these criteria.* Eligibility* I understand that the organization I represent is not eligible to apply to this program until any outstanding final reports for SOSJ grants have been submitted and approved.* Conditions* I accept the conditions of this program and agree to accept SOSJ Commandery Council’s decision.* Accuracy* I confirm that to the best of my knowledge the statements in this application are complete and accurate.* Returns* I agree that the organization I represent will return a portion or all of the funding if the project is not carried out as described in the application.* Final Report* I agree that a completed final report including financial verification will be provided to SOSJ within 60 days of completion of the project.* Name of Authorized Representative* Position/Title* Date of Application* By clicking the submit button below, your personal signature is implied. 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