Club Grant Application

NOTE: Please complete ALL sections of this form. Clubs eligible for the former ‘Lotteries Grant’ funding will automatically apply for lotteries funding in addition to the Club Grant with completion of this form.

Club Name:

Title:

Contact Name:

Address:

City:

Postal Code:

Phone

SECTION A:

Category (please check all that apply):

Grassroots Development GrantLearn to Train Club Outreach GrantSport for Life Masters GrantAdAS Program Hosting Grant

SECTION B:

Total Number of Registered Members by Stream:

Recreational - (AquaGo, AquaSquirts):

Recreational - Masters:

Provincial Stream (including Limited Competitive):

National Stream:

AdAS:

TOTAL NUMBER OF ATHLETES:

Please list the Competitions your club will be participating in below:

Competition A

Competition Name:

Location

Dates:

# Athletes attending:

Competition B

Competition Name:

Location

Dates:

# Athletes attending:

Competition C

Competition Name:

Location

Dates:

# Athletes attending:

Competition D

Competition Name:

Location

Dates:

# Athletes attending:

Does your club receive Provincial funding from any other sources?

YesNo

Please provide the source(s) and funding amounts:

Please provide all programs names along with expenditures and budgeted amounts for each program:

Sample Program Name: Recreational
Sample Ependitures: Rental Fees, Coaching Costs, Competition Expenses, etc...
Sample Budgeted Amount: $2000
You may be asked to supply receipts and/or financial records.