ARCHIVED - Basic Organizational Capacity Contribution Program Funding Application (2015-2016)

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Form Instructions

PAW# 1323247 (2015-2016) v2

Privacy Act Statement:

The information you provide in this document is collected under the authority of Contributions to support organizational capacity of representative Aboriginal organizations for the purpose of building organizational capacity within representative Aboriginal organizations. Information on individuals is used by Aboriginal Affairs and Northern Development Canada Basic Organizational Capacity Program employees who need to know the information in order to respond to your request and/or the program requirements. We do not share personal information with other government departments or organizations. The information will be kept for a period of 30 years. Individuals have the right to the protection of and access to the information provided under the Privacy Act. The information collected is described under the Treasury Board Personal Information Bank INA PPU 300 which is detailed at InfoSource.

Are you applying for a multi-year agreement?

Part A - Applicant Information

Organization

Scope of Organization's Activities:

Scope of Organization's Activities:

Contact (person authorized to sign on behalf of the organization)

Applicant Address

Have you previously received funding from the Department of Aboriginal Affairs and Northern Development?

Do you employ a former (in the last twelve months) public servant in the federal government who is under the Values and Ethic Code for the Public Service?

Part B - Proposal Summary Information (Proposal/Work plan can be submitted as a file attachment through Part E of this form)

Part C - Work Planning Template

Year 1

Part D - Budget Summary

Expenditure Type Budgeted Expenditures
  Year 1 Year 2 Year 3 Year 4 Year 5
Total Expenses
Salaries
Staff
Elected
Specify
Sub-Total Salaries
Rent
Operation Costs
Travel - Staff
Travel - Non-Staff
Sub-Total Travel
Consultant
Legal Services
Sub-Total Consultants
Specify
Sub-Total Operation Costs
Administration Costs
Equipment
Meeting Expenses
Supplies
Telephone and Fax
Insurance
Translation
Miscellaneous
Specify
Sub-Total Administration

Part E - Supporting Documentation

The mandatory documents which should be provided with the funding application are listed in the Name of Supporting Document drop down list.

Attachment(s):

Indicate the name(s) of supporting document(s) being submitted and the method of submission.

PART F - Affirmation

I affirm that the information in this funding application is accurate and complete. I agree to submit an annual audited financial statement that will show all sources of funding received as per AANDC Year-end Reporting Handbook.

Signing Authority

Witness

Office Use Only

 

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