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Commemorative Partnership Program Community War Memorial Funding Application Instructions • We Strongly Encourage You to Complete the Form Electronically

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Commemorative Partnership Program Community War Memorial Funding Application Instructions • We Strongly Encourage You to Complete the Form Electronically Protected B when completed Commemorative Partnership Program Community War Memorial Funding Application Instructions • We strongly encourage you to complete the form electronically. It includes features to help simplify the application process (e.g., automatic calculations). You may also print off the application form and complete it by hand. • Any changes made by hand after the form is completed and printed must be initialled by the individual authorized to sign the form. • If you do not have enough space to answer a question, please attach a separate sheet. • Quarterly deadlines: January, April, July and October (1st business day of the month). • It is strongly recommended that applications be submitted at least three (3) months before the start date of the proposed project to allow for processing and notification of funding. For example, if your project start date is May 1, you should submit your application by the first business day of the January deadline. • Ensure budget information is complete and calculated correctly. • All signatures must be handwritten. • Remember to include all required documents with your application (please refer to the checklist outlined in Part I of this application form). • You must complete all required fields before submitting your application. Once completed, this form can be scanned and transmitted by e-mail or sent by mail. It must be received or post- marked no later than the stated deadline date. • Keep a copy for your records. Contact information If you have questions or require assistance with the application, please contact the Partnerships Unit by calling toll free at 1-866-522-2122 or by email at [email protected]. Please send your completed application and all accompanying documentation to Veterans Affairs Canada: Veterans Affairs Canada Commemorative Partnership Program 191 Great George Street, Room 304 PO Box 7700 Charlottetown, PE C1A 8M9 By e-mail: [email protected] VAC1064e (2016-06) Page 1 of 12 Fields with an asterisk (*) are required. Ce formulaire est disponible en français. Protected B when completed Commemorative Partnership Program Community War Memorial Funding Application Part A - Applicant information Name of organization* Organization's status Registered charitable No. GST/HST/BN No. profit non-profit Mr. Mrs. Ms. Miss Other (specify) Contact person (last name, first name) Title Preferred language of communications Telephone (Country Code, Area Code, No.) English French Canada/US Other ( ) Other telephone (Country Code, Area Code, No.) Facsimile No. (Country Code, Area Code, No.) Canada/US Other ( ) Canada/US Other ( ) Mailing address (No., Street, Apartment No., PO Box, RR No.) City/Town/Village Country Province/Territory/State Postal Code/ZIP E-mail address Organization's Website (if applicable) Part B - Organization objective and history Brief description of organization's mandate/objectives Has your organization previously received partnership funding from Veterans Affairs Canada (VAC)? Yes No If yes, project name Date of project (yyyy-mm-dd) Funding amount $ VAC1064e (2016-06) Page 2 of 12 Fields with an asterisk (*) are required. Ce formulaire est disponible en français. Protected B when completed. Name of organization* Part B - Organization objective and history (continued) If no , has your organization successfully completed other projects? If yes, explain Part C - Project information How will this project recognize all those who served in Canada's efforts during war, military conflict and peace? How will it engage youth, Veterans, Canadian Armed Forces members and/or the general public? (Please attach a separate sheet if necessary.)* Total anticipated target audience (please indicate total number of Number of people expected to access the monument or addition over a one-year period) Veterans Number of Canadian Armed Number of youth Forces members Other What are the planned outcomes of the project? What does this project hope to accomplish?* How will you determine that you successfully achieved your planned outcome(s)? Note: A final report must be submitted at the conclusion of the project. The report will enable the organization to fulfill its obligation of accountability to VAC.* VAC1064e (2016-06) Page 3 of 12 Fields with an asterisk (*) are required. Protected B when completed. Name of organization Please indicate by checking one of the boxes below: The project is for the restoration of an existing memorial (go to Part D). The project is to build a new memorial or an addition** to an existing memorial (go to Part E). ** For the purpose of this program, an addition is a project involving new construction directly or complementary (e.g., walls and columns) to an existing memorial. Part D - Restoration of an existing memorial Name of memorial National Inventory of Canadian Military Monuments registration no. (if applicable) Ownership of memorial (e.g., municipality, Royal Canadian Legion, etc.) Street address or nearest cross streets City Province/Territory Description of the location (e.g., in a park, on a street corner) Country Who does this memorial commemorate? (check all that apply) local citizens all Canadians those who lost their lives those who served Specify conflicts/wars/peacetime efforts Year of construction (if known) Describe any previous conservation work or repairs. (If known, include the type of work and date completed. Also provide photographs of the memorial before and after construction work, and copies of any repair/conservation drawings, if available.) VAC1064e (2016-06) Page 4 of 12 Fields with an asterisk (*) are required. Protected B when completed. Name of organization Part D - Restoration of an existing memorial (continued) Estimated project start date (yyyy-mm-dd) Estimated project completion date (yyyy-mm-dd) Describe the current condition and issues affecting the memorial. (Please include a copy of any condition assessment/report (if applicable), and contractors' quotes for all planned restoration work.) Describe in detail the scope of the planned conservation work to address the problems affecting the memorial (step-by-step solutions). How will your organization support the ongoing maintenance once the memorial has been restored? Note: For restoration projects, please proceed to page 7 to complete Part F (financing section). VAC1064e (2016-06) Page 5 of 12 Fields with an asterisk (*) are required. Protected B when completed. Name of organization Part E - Construction of a new memorial or addition Estimated project start date (yyyy-mm-dd) Estimated project completion date (yyyy-mm-dd) Describe the project in detail, including location. (Please attach required photographs of the proposed site.) Proposed name for the new memorial or, for additions, name of existing memorial* Ownership of the new memorial or addition. (Please attach required document to identify ownership, as outlined in the Program Guidelines.)* Note: The Government of Canada will not, under any circumstance, assume any ownership or responsibilities related to the ownership of cenotaphs, monuments or major additions constructed through the Commemorative Partnership Program. Will the new memorial or addition be constructed on Crown land? (This includes land owned by any federal government department, agency or organization.) Yes No Who does this memorial commemorate? (check all that apply) local citizens all Canadians those who lost their lives those who served Specify conflicts/wars/peacetime efforts: Will individual names be inscribed on the major addition? Yes No If yes, approximately how many? Please indicate proposed text below (if applicable) VAC1064e (2016-06) Page 6 of 12 Fields with an asterisk (*) are required. Protected B when completed. Name of organization Part F - Project budget Planned expenditures • Include all expenditures related to the project, including in-kind. • Refer to the guidelines for eligible and ineligible expenditures. • Note: Please include percentage of taxes not already reimbursed as an eligible expense. • Copies of all contractors' estimates and/or quotes for labour and materials must be included with this submission. Support from VAC may be requested for up to 50 percent of the eligible expenses, not exceeding a maximum of $50,000. Only 25 percent of the overall budget can be contributions in-kind. In-kind $ Planned expenditures Cash $ (must also be reported as a revenue) Subtotal Contingency (maximum 10%) Total project cost - Cash and in-kind Total planned expenditures (A) $ VAC1064e (2016-06) Page 7 of 12 Fields with an asterisk (*) are required. Protected B when completed. Name of organization Part F - Project budget (continued) Anticipated revenue Indicate in the table below the sources of revenue you have secured/enlisted for this project. • Financial support from other organizations, federal departments and agencies (excluding the funding requested from VAC), and municipal and provincial/territorial governments. • Donations in-kind (itemize and list estimated donations). • Organization's own funding. • If more space is required, submit the information on a separate document. Amount $ Other Government of Canada funding (specify if pending or confirmed) Municipal/provincial/territorial support Private sector support Donations Fundraising Organization's own funding In-kind support (e.g., labour, materials, consulting fees) Other (specify) Total anticipated revenues (B) (If total revenue covers or exceeds expenditures, VAC is unable to fund the project.) Funding required Total planned expenditures
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