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HomeMy WebLinkAboutFebruary 18, 2016 - Council - Addendum THE CORPORATION OF THE MUNICIPALITY OF BAYHAM COUNCIL MEETING ADDENDUM MUNICIPAL OFFICE Thursday, February 18, 2016 1. ADMINISTRATION A. Straffordville Giants Fastball Municipal Assistance Application Page 2 RECEIVED Municipality of Bayham FEB 1 6 2016 Municipal Grant/Assistance Application Form MUNICIPALITY BAYHAM *Note: Grants or other assistance in any one year or over several years is not to be interpreted as a commitment of future years funding. A. Name of Organization and Mailing Address: -7- Wer( F Soc \e GI G vl\s S.k"Ie a`\ ,O dSc5 XSfrn }To v) 01- ix Contact Person Stq)kulQ ! Position Telephone# 'R _l oc y jtm(6, 3Og1 : Categories of Request for Assistance (check appropriate box(es)): e Financial Grant ❑ $ © Fee Waiver(s) 124 o Staff Support ❑ o Equipment/Materials Supply ❑ ® Insurance Coverage ❑ o Use of Municipal Property/Facilities o Other ❑ C: Details of Request for Assistance: Note: If this application includes any assistance other than direct financial grant, please outline details of request (ie: type and estimated hours of staff support; facilities to be used; dates; etc.) 4.(/901 .r/2 y / ("` Ho ityle_ C e_c aryl �irQ(:,Tice : c Ut ci (yS 0 cern. .fTIPet 4p /( 3rd .l"0 "lcV I ki.tiN aO (4 Horn ?rtes royryl may 1st- 1 Sc trvt Sct y core, i �' 1 frta irt/� ties ;vs ne,ci• (homdet s _ Page 3 is Purpose of Grant/Assistance: (ie: services to be provided, donations, etc) covey -mss rex*:re-cf T©(- e4 0)-1 (tette Curti-1 basoho (I 8(10,2 S E: #I rganization Background: (Note: Group Constitution/By-laws may be submitted in place of completing items 1 and 2) 1. Provide a brief outline of your organization, and indicate if it is incorporated as a non-profit Wanization. f( I t)(\ c"C) IA me 6N ( s-\'b Gt l 4ept'Vk 2. What are the general jectives/services of your organization?•i ,�/ cc)L�( S4 (- � , Lr ' 1(( ° cc- 1 e(S 4' Ct 05 3. How many vol eers participate in your program? 4. Does your organization provide a service to: a) All citizens __ _ b) A specific group c) A specific area 5. In what geographical area does your organization operate? 6. For what specific purposes are the requested grant funds to be utilized within your organization? 7. Has your organization requested financial assistance in the last 12 months from other government organizations? If so, please list with amounts received. 8. What other steps are being taken to increase revenues? (ie: admission fees etc) Page 4 9. Have ru received funding from the Municipality in prior years? If so, how much? 10. Will your organization ever be self supporting? 11. List of Executive of your Organization 12. Submit an estimate of operating revenues and expenditures for your organization for the current fiscal year on the attached form. (Note: Prior years Statements can be submitted or completed on attached form) Date: -Feb //cO (6 i Name and Title of Officer making Application Iture ✓ � � ,76i Telephone Number Page 5 Statement of Revenues and Expenditures (name of organization) For the Year Ending Sources of Revenue Current Budget Last Year Actuals From Operations (list separately) $ $ (Include ticket sales, user fees, fundraising events, service charges, etc.) From Grants—include all municipal,provincial, federal Total 'revenues: $ $ Page 6 Expenditures Employment Costs: Administration Costs: (List separately) Include utilities, maintenance, supplies, repairs,permit fees, etc. Donations etc.—List All: (Individual donations may be summarized) Total Expenditures: $ $ Surplus/Deficit: Surplus/Deficit from prior year: Cash on hand: File: Forms/Application-Municipal Assistance