Funding Application Form

Name of Project/Organization:

Contact:

Address:

City:

Province:

Postal Code:

Phone:

Fax:

Email:

Organization Type: ------Select Type------ Fishing Club Service Club Community Organization Educational Facility Other

If "Other" Please Explain:

Project Type: ------Select Type------ Fish Rearing/Stocking Habitat Creation/Enhancement Resource Education

Project Objectives:

Project Methods:

Specific Use of Requested Funding:

Total Estimated Cost:

Number of Years Until Project Completion:

Number of Additional Revenue Sources:

Number of Additional Revenue Sources
Confirmed But Not Yet Received:

Number of Other Fund Raising Activities:

Number of Volunteer Hours to Date:

Number of Volunteer Hours Upon Completion:

Value of Materials Donated or Purchased to Date: