Funding Application Form

We are currently working to improve the accessibility of the Funding Application Form. If you require assistance in applying for funding, please contact: pb-dgp@justice.gc.ca.

PDF Version

Before completing the form, review the program priorities below of the selected funding program because only projects that relate to these priorities can be considered for funding

Select the program you are applying for:


 Aboriginal Justice Strategy - Capacity Building
  1. Build internal capacity and provide training for existing Aboriginal community justice programs in program reporting (e.g. data collection, evaluation)
  2. Build internal capacity and provide training initiatives for existing Aboriginal community justice programs that include various justice stakeholders
  3. Build internal capacity and provide training for existing Aboriginal community justice programs on emerging community justice-related issues
  4. Build bridges, foster partnerships and seek opportunities for collaboration (for example between the mainstream justice system and Aboriginal communities as well as with other community justice programs), through capacity-building events such as regional gatherings
  5. Build bridges, foster partnerships and seek opportunities for collaboration (for example between the mainstream justice system and Aboriginal communities as well as with other community justice programs), through a gap analysis, needs assessment or environmental scan

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: ajs-sja@justice.gc.ca


 Access to Justice for Aboriginal Women - Justice Partnership and Innovation Program

To support initiatives that contribute to reducing the vulnerability of young Aboriginal women to violence

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Access to Justice in Both Official Languages Support Fund
  1. Increase the capacity of the justice system and its stakeholders to offer justice services in both official languages
  2. Increase awareness in the legal community and official language minority and majority communities concerning their rights and issues related to access to justice in both official languages

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Family Violence - Justice Partnership and Innovation Program
  1. Strengthen the justice systems response to family violence
  2. Promote continued public awareness of family violence and public involvement in the response to family violence

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Justice Partnership and Innovation Program - General
  1. Promote the equitable representation in the legal system of Mtis and Non-Status Indians by encouraging them to pursue their studies in law
  2. Promote and encourage involvement in the identification of emerging trends, issues and/or gaps and possible responses with respect to the justice system
  3. Build knowledge, awareness and understanding among justice stakeholders and/or the public on justice issues, and other emerging justice related issues
  4. Provide operational funding to the International Centre for Criminal Law Reform (ICCLR) and Criminal Justice Policy

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Supporting Families Fund - Public Legal Education and Information (PLEI)
  1. To develop PLEI activities and resources that will enhance the knowledge of families experiencing separation and divorce about parenting arrangements, child/spousal support guidelines, and support/access enforcement measures and help facilitate access to the family justice system for target populations
  2. To develop professional training activities and resources to support continuing education efforts for professionals, intermediaries and service providers who are directly involved with divorcing and separating families on parenting arrangements (custody and access), family support and support enforcement measures

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Supporting Families Fund - Pilot Projects

To develop, implement and evaluate innovative family justice programs and services that promote compliance with financial support and custody/access obligations and facilitate access to the family justice system for target populations.

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Victims Fund - Child Advocacy Centres Initiatives
  1. To support the creation of new child advocacy centres
  2. To support new child advocacy centres that are under development or in the early phases of development
  3. To support enhancements to existing child advocacy centres or similar models of service

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Victims Fund - Victims and Survivors of Crime Week

To raise awareness about the issues facing victims and survivors of crime about the services, assistance and laws in place to help victims, survivors and their families

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: victimsweek-semainedesvictimes@justice.gc.ca


 Victims Fund - Measures to Address Prostitution (Law Enforcement Agencies)

To provide new or enhanced support or outreach activities to assist sellers of sexual services wishing to leave prostitution.

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Victims Fund - Measures to Address Prostitution (NGOs and Government)

To provide or enhance services that assist sellers of sexual services in leaving prostitution.

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Victims Fund - Project Funding
  1. Promote access to justice and participation by victims in the justice system
  2. Promote the development of law, policies and programs for victims
  3. Promote the implementation of principles, guidelines and laws designed to address the needs of victims of crime and articulate the victim's role in the criminal justice system
  4. Increase knowledge and awareness of the impact of victimization, the needs of victims of crime, available services, assistance and programs, and relevant legislation
  5. Encourage governmental and non-governmental organizations to identify victim needs and gaps in services, and develop and deliver programs, services and assistance to victims
  6. Promote capacity-building within non-governmental organizations

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Victims Fund - Provincial Territorial Program Funding

Assist in the implementation of federal and provincial/territorial legislation for victims of crime, particularly provisions of the Criminal Code (such as victim impact statements, publication bans, restitution, victim surcharge, testimonial aids, etc.)

Implementation of provincial victims' legislation and the Canadian Statement of Basic Principles of Justice for Victims of Crime through the development and enhancement of police, court, Crown or system-based victim assistance programs, conferences, public legal education and similar initiatives

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Action Plan to Address Family Violence and Violent Crimes Against Aboriginal Women/Girls
  1. Promote access to justice and participation by victims in the justice system
  2. Promote the development of law, policies and programs for victims
  3. Promote the implementation of principles, guidelines and laws designed to address the needs of victims of crime and articulate the victims role in the criminal justice system
  4. Increase knowledge and awareness of the impact of victimization, the needs of victims of crime, available services, assistance and programs, and relevant legislation
  5. Encourage governmental and non-governmental organizations to identify victim needs and gaps in services, and develop and deliver programs, services and assistance to victims
  6. Promote capacity-building within non-governmental organizations

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: pb-dgp@justice.gc.ca


 Youth Justice Fund
  1. Establish special measures for violent young offenders
  2. Improve the system's ability to rehabilitate and reintegrate young offenders
  3. Increase the use of measures, outside the formal court process, that are often more effective in addressing some types of less serious offending
  4. Establish a more targeted approach to the use of custody for young people
  5. Increase the use of community-based sentences for less serious offending

Additional Information

This funding application form was developed to make the process as clear and as easy to complete as possible. Once completed this application should contain of all the necessary information that will be critical for making a funding decision. Several questions include tool tips (represented by a question mark to the right of the question) which provide more specific guidance on what information you should include in your response. The tool tips can be seen by hovering your cursor over the question or by clicking on the question mark (if present).

If you have additional questions while completing this application, staff would be happy to help you and are available by email at: YJF_FSJJ@justice.gc.ca


Please note that funding is limited, and therefore, not all eligible projects will be funded. The Department of Justice Canada thanks you for taking the time to complete and submit an application for funding.

Please answer the following questions to determine if you are eligible for funding

Is this project:

  • A new program for your organization
  • An enhancement to an existing program
  • An adaptation of an existing program
  • A continuation of an existing program? (project is not eligible for funding)

Will your project target youth currently in conflict with the law: a young person, twelve years of age or older, but less than eighteen years, who is alleged to have committed an offence or who has been found guilty of an offence?

  • Yes
  • No

Will your project target people who work with these youth (for example, youth workers, corrections personnel, police)?

  • Yes
  • No

Which of the following will your project target

  • Youth involved in the justice system or those that work with these youth
  • Youth involved in the justice system with mental health issues or cognitive disabilities
  • Youth involved in the justice system with illicit substance abuse issues
  • Youth involved in the justice system involved in gangs or vulnerable to gang involvement.

Office use only

File #

Date Received

Tell us about you

1. Applicant Information

I am an

  • organization applying for funding
  • individual applying for funding
  • other level of government applying for funding

Street Address (if outside of Canada please provide full address including city, state and country in this field)



City

Province/Territory

Postal Code

Phone

Fax

Website

2. Primary contact for this application

First Name

Last Name

Salutation

Title (if applicable)

Phone

Fax

Email

  • Authorized to sign on behalf of the organization / entity
  • Same address as main address provided above (if checked, skip address fields below)

Street Address (if outside of Canada please provide full address including city, state and country in this field)



City

Province/Territory

Postal Code

3. Would you like to add additional person(s) with signing authority? (2 maximum)

Person 1

First Name

Last Name

Salutation

Title

Street Address (if outside of Canada please provide full address including city, state and country in this field)



City

Province/Territory

Postal Code

Telephone

Fax

Email

Person 2

First Name

Last Name

Salutation

Title

Street Address (if outside of Canada please provide full address including city, state and country in this field)



City

Province/Territory

Postal Code

Telephone

Fax

Email

4. Is your organization a (select one)

  • Band, First Nation, Tribal Council, local, regional or national Aboriginal organization
  • Non-profit organization, society or association
  • Education-related institution or association (e.g. school board, university etc.)
  • For profit organization undertaking "not for profit" work
  • Research and/or evaluation organization
  • Other (please specify):

5. Is your organization incorporated?

  • Yes
  • No

6. Is your organization a registered band?

  • Yes
  • No

7. Is your organization registered as a charitable organization with the Canada Revenue Agency?

  • Yes
  • No

8. What is the primary work of your organization (300 words maximum)?






9. What is the mandate of your organization?




For Québec organizations only

Are the majority of your members from the Québec public sector, that is, appointed by the Government of Québec, a minister, a government agency, a municipal body, a school board or another public agency?

  • Yes
  • No

Is your personnel appointed in accordance with the Public Service Act (of Québec - Chapter F-3.1.1)?

  • Yes
  • No

Is more than half of your financing derived from Québec public funds, that is, from the consolidated revenue fund, a government agency, a municipal body, a school body or another public agency?

  • Yes
  • No

If you answer "yes" to any one of the three questions in this section, your organization is required to provide a copy of the Order in Council allowing your organization to negotiate and enter into an agreement with Justice Canada either with your completed funding application or before a formal agreement will be offered by Justice Canada. For more information about this requirement please see, "An Act respecting the Ministère du Conseil executive" (M-30) on the Government of Québec's website.

Tell us about your project

10. Project Title

11. Anticipated timeframe (yyyy-mm-dd). Please select the date from the date picker.

Start Date

End Date

12. Will this funding application be submitted to another federal department?

  • Yes
  • No

13. Project Description (500 words maximum)






14. Describe why your project is needed (500 words maximum)?






15. To be funded, your project must relate to at least one of the priorities of the funding program you are applying to. Select the funding program priorities that relate to your project and explain how your project will address the priorities

Funding Program Prioritie(s)

  • Establish special measures for violent young offenders
  • Improve the system's ability to rehabilitate and reintegrate young offenders
  • Increase the use of measures, outside the formal court process, that are often more effective in addressing some types of less serious offending
  • Establish a more targeted approach to the use of custody for young people
  • Increase the use of community-based sentences for less serious offending

Briefly explain how your project addresses the priority







Add additional prioritie(s)





16. What is your organization's expertise and/or experience to undertake this project (300 words maximum)?







17. Who will directly benefit (target population) from this project?

  • Male youth involved in the justice system
  • Female youth involved in the justice system
  • Ethno cultural or visible minority youth involved in the justice system
  • First Nations - on Reserve youth involved in the justice system
  • First Nations –off Reserve , Inuit or Métis youth involved in the justice system
  • Official language minority youth involved in the justice system
  • Other distinct populations of youth involved in the justice system
  • Youth justice system professionals and front line workers
  • Other professional groups, e.g., health or child welfare systems
  • Other level of government (provincial, territorial or municipal)
  • Northern community
  • Urban community
  • Rural/remote community

18. Explain how your project demonstrates sensitivity to diversity and gender equality issues (300 words maximum)







19. Explain how the objectives of sustainable community development will be supported (300 words maximum)







The Department of Justice is committed to enhancing the vitality of the English and French linguistic minority communities in Canada, supporting and assisting their development, and fostering the full recognition and use of both English and French in Canadian society

20. Describe how your project takes into consideration the needs of the French-speaking people outside Quebec or English-speaking people in Quebec (300 words maximum)







21. How will the results and findings of your project be shared or communicated? (300 words maximum)







22. How will you measure the impact or success of your project (select all that apply)?

  • Evaluation (including third party or in-house evaluations)
  • Satisfaction Survey
  • Pre- and post-participant questionnaires
  • Data collection against key performance indicators
  • Other (please specify):

23. If your project will be evaluated, indicate who will do the evaluation and provide an overall description of your evaluation plans or approach (300 words maximum)







24. Provide the name(s) of member(s) of your organization that will help to either deliver or oversee the project

Name and/or position title

Role / Responsibility

25. Will your project require the support or participation of others?

Name of Supporter

Describe the nature of the support (i.e. referral source, advocate, donating space, providing advice, volunteer etc.




Has the support been confirmed?

  • Yes
  • No

Is this a new or on-going relationship?

  • New
  • On-going

Project Workplan

26. What is the objective(s) of your project (must be specific, measurable, and possible to achieve -
3 maximum)?

First objective




Second objective




Third objective




27. Using this table, please list the activities including the timeframe, who will be responsible, and the outputs for each activity that you will undertake to complete this project

Activity Title 1

Activity Title Timeframe (from-to)

Responsibility

Outputs (products and or services)

 

Activity Title 2

Activity Title Timeframe (from-to)

Responsibility

Outputs (products and or services)

 

Activity Title 3

Activity Title Timeframe (from-to)

Responsibility

Outputs (products and or services)

28. Budget

Current project start and end dates

Start Date (yyyy-mm-dd)

End Date (yyyy-mm-dd)

A) Justice Canada Cash Contributions

Expense Category Expense Description Fiscal Year (s):
2014-2015
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
Sub-Totals  
Grand Total  

B) Other Cash Contributions

Funding Source Expense Category Expense Description Fiscal Year (s):
2014-2015
 
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
 
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
 
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
 
  • Administrative fee
  • Audit
  • Evaluation
  • Office equipment, Furniture and Supplies
  • Other (specify in expense item text field)
  • Professional fees
  • Program delivery or direct program costs
  • Salaries (including fringe benefits)
  • Training
  • Travel
   
Sub-Totals  
Grand Total  

C) In-Kind Contributions

In-kind is the amount of funding* that is given in goods and/or services rather than money

Funding Source Expense Description Fiscal Year (s):
2014-2015
     
     
     
     
Sub-Totals  
Grand Total  

* The amount of funding is an estimate of the monetary value of the in-kind provided

29. If applicable, provide any additional information about this project that you think is relevant and that we should know (300 words maximum)






30. If you have received funding from the federal government within the past five years, was an audit conducted?

  • Yes
  • No

31. Does your organization receive a GST/HST rebate from the federal government?

  • Yes
  • No

Youth Justice Program - Program Specific Section

Which of the following Youth Justice Program performance indicators will your project most likely address?

  • Collaboration by project partners on learnings and promising practices
  • Rehabilitative and reintegration opportunities developed
  • Alternative approaches to youth justice practices developed
  • Programs aimed at youth involved in or at risk of involvement in gangs
  • Drug treatment options developed for youth involved in the youth justice system

What are the expected outcomes of the project?

Expected Outcome

Expected Indicator

Expected Outcome

Expected Indicator

Expected Outcome

Expected Indicator

Expected Outcome

Expected Indicator

Is the provincial/territorial government department responsible for youth justice in your jurisdiction aware of this project?

  • Yes
  • No

Which of the following best describes your project activities

  • Development/implementation of a pilot project
  • Training
  • Conference/Worksho
  • Evaluation
  • Research
  • Information Sharing

Have you consulted with your target audience about this project?

  • Yes
  • No

Please explain:

Conditions

In the event that your funding application is successful, you will be required to provide banking information in order to permit electronic payments.

Departmental funding may be used only for the purposes specified in this application. Once the Department has agreed to grant financial assistance, no major change can be made to the project without departmental approval (in each case, the Department shall determine what constitutes a major change). Funds not used for these purposes must be returned to the Department.

The organization bears full responsibility for its debts. The Department will not consider any request for assistance in settling debts. The organization must agree to comply with all provincial, territorial and federal legislation.

The Department's financial contribution must be explicitly acknowledged and must be mentioned in publications funded by the Department. A typical form of acknowledgement is: "We acknowledge the financial support of the Department of Justice Canada".

With regard to the project or programming for which funding is requested, the organization shall agree to comply with the spirit and intent of the Official Languages Act by implementing the appropriate linguistic measures.

By signing this application, (the applicant) authorizes the Department of Justice Canada to disclose any information received in this application within the Department and the Government of Canada or to outside entities for the following purposes: to reach a decision on this application, to administer and monitor the implementation of the project or programming, or to evaluate the results of the project or programming after project completion. This disclosure of any information received in this application may also be used to reach a decision on any other application of the applicant for funding under any other departmental program.

In the event of an access to information request regarding the present funding application or any relevant information about the organization in the Department's possession, the information provided to the Department will be entirely disclosed, with the exception of personal information, which will be treated in accordance with the Privacy Act.

Any person lobbying on the recipient's behalf must be registered under the federal Lobbyists Registration Act.

Declarations

I declare that

  • the information in this application is accurate and complete;
  • the application is made on behalf of the organization named, whose name appears in knowledge and consent;
  • if financial assistance is granted, the organization shall undertake to provide financial reports on results pursuant to the requirements of the Department of Justice Canada;
  • if financial assistance is provided, the organization shall agree to an assessment programming pursuant to the requirements of the Department of Justice Canada;
  • no public servant or holder of public office, past or preseVnatlu,e s wahnidc Ehth iicss C oidne breach for the Public Sector or the Conflict of Interest Act shall derive a direct benefit from the requested funding;
  • this organization has not paid or agreed to pay, directly or indirectly, and agrees directly or indirectly, any contingency fees for the solicitation, negotiation or acquisition of funding for the purposes of this application.

Applicant

Name of Person with signing Authority

Position

I agree to the conditions and declarations


Date

Please email this completed form and additional documents to: pb-dgp@justice.gc.ca

Date modified: