Funding Application Form
National Victims of Crime Awareness Week 2012
Moving forward
APPLICANT INFORMATION:
Name of Organization:
Address:
Telephone Number:
Fax Number:
Email Address:
Website Address:
Contact Name and Title:
DESCRIBE YOUR ORGANIZATION
Please describe your organization and mandate in two to three sentences:
Type of organization: (Select one)
- Aboriginal government/Band or Tribal Council
- Aboriginal voluntary organization
- Community coalition or network
- Educational Institution or association
- Not-for-profit business
- Private sector organization, association or society
- Not-for-profit professional organization, association or society
- Not-for-profit voluntary organization, association, society or group
- Other (please specify):
At what level is your organization active? (Select all that apply)
- Local
- Municipal
- Regional
- Provincial/Territorial
- National
- International
Date your organization was established:
Is your organization incorporated?
- No
- Yes *
* Please include a copy of the certificate and the articles of incorporation OR the letters patent in your email submission.
At what level is your organization incorporated?
- Provincial/Territorial
- National
CURRENT / PREVIOUS FUNDING FROM THE DEPARTMENT OF JUSTICE CANADA
Please list all the funding received from the Department of Justice Canada since April 1, 2007.
| Date | Project Title | Amount | Results Achieved |
|---|---|---|---|
FOR QUÉBEC ORGANIZATIONS ONLY
Are the majority of your members from the Québec public sector (i.e. appointed by the Government of Québec, 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 (i.e. from the consolidated revenue fund, a government agency, a municipal body, a school body or another public agency)?
- Yes
- No
If you answered “yes” to one or more of these questions, you must obtain and attach a copy of the Order in Council allowing your organization to negotiate and enter into an agreement with the Department of Justice Canada to your email submission.
INFORMATION ABOUT YOUR PROJECT
Project Title:
Project start date:
Project end date:
PROJECT DESCRIPTION
Most projects that take place during NVCAW fall into one of three general categories. Please choose the category/categories from the list below that best describe your event. If your event does not fall within one of the categories listed, please indicate what your project will be in the section marked “other.”
My project will be a(n):
- General or specific awareness-raising campaign, event, or ceremony (e.g. a proclamation ceremony at City Hall, newspaper ad campaign etc.)
- Event that draws specific attention to skills / research / advancements made respecting victim issues (e.g.: training session, workshop etc.)
- Event that recognizes the dedication of those that work to support and assist victims of crime (e.g. volunteer recognition event, award ceremony etc.)
- Other (please specify):
Details about my project:
In the space below, please briefly describe the activities that will take place, why you want to take on this project and who will be affected by the project. Please keep your description under 150 words.
7. PARTNERSHIPS
Please identify the partners that you will be working with for this project and their in-kind / financial contributions. (Maximum 100 words).PROJECT OBJECTIVES AND INDICATORS OF SUCCESS
To qualify for funding through the Victims Fund, all NVCAW projects must meet the following objective:
Contribute to increased knowledge and awareness of the impact of victimization, the needs of victims of crime, available services, assistance programs and legislation.
Please describe how your project meets this objective and list a maximum of three indicators of the success of your project. For example, if your event will be a community BBQ that will raise awareness about local victim serving organizations, an indicator of success would be that X number of people attended the event. (For more information on performance indicators, please see the definition of “indicator” at: http://www.swc-cfc.gc.ca/fun-fin/wcf-fcf/guide-eng.html#appendix1)
How will your project meet the objective above?
What are three indicators of the success of your project?
DIVERSITY / GENDER EQUALITY
If your project takes the needs of people who come from different social and cultural groups, equity groups and/or diverse communities into consideration, please explain how. (Maximum 100 words)
OFFICIAL LANGUAGE MINORITY COMMUNITIES
If your project demonstrates sensivity to the needs of Official Language Minority Commynities (i.e Francophones who live outside of Quebec, or Anglophones who live in Quebec), please explain how. (Maximum 100 words)
PROJECT WORKPLAN
Please outline your work plan. You may describe it in the space below, or include it as a separate attachment in your email submission. (For an example of a work plan, please see Annex II of http://www.swc-cfc.gc.ca/fun-fin/wcf-fcf/form-eng.pdf)
MEASURING THE IMPACT OF YOUR PROJECT
Describe how you intend to measure the impact of your NVCAW 2012 event / project. Please keep your evaluation plan “short and sweet.” (I.e. a participant survey, the number of attendees at your event, number and frequency of radio and newspaper ads.) Please keep your answer under 150 words.
PROJECT DELIVERABLES
Upon the completion of your NVCAW 2012 project, you will be required to submit a Project Summary Report, which will be available to download from the NVCAW 2012 website (www.victimsweek.gc.ca). Along with this summary report, please send in any products, materials and media coverage (e.g. news clippings, blog entries etc) that were produced as part of your project and photos of the event (if applicable). Please indicate the date by which you will submit your Project Summary Report, any products, materials and media coverage produced as part of your project and photos of the event (if applicable):
Please indicate the date by which you will submit your Project Summary Report, any products, materials and media coverage produced as part of your project and photos of the event (if applicable):
PROJECT BUDGET
Please indicate the budget for your project by completing the chart on the following page. Please add extra rows if you need to. The Department of Justice Canada can provide up to a maximum of $10,000 per project. Be sure to include detailed information on the costs, along with a breakdown by line item.
Include detailed information on all sources of revenue (financial and in-kind from ALL sources) and all expenses (financial and in-kind) by fiscal year (e.g. April 1, 2011 to March 31, 2012). The federal government fiscal year starts on April 1 of a given year and ends on March 31 the following year – therefore all expenditures must be expended within that fiscal year.
Note: Funding for National Victims of Crime Awareness Week 2012 projects
spans two fiscal years. Funding will be available up to March 31, 2012
(i.e. in the federal government’s 2011-2012 fiscal year) for planning
and organizing activities prior to the Week itself, as well as from April 1,
2012 to April 30, 2013 (i.e. in the federal government’s 2012-2013 fiscal
year) for hosting/supporting an event during the Week. In other words,
funding that spans two fiscal years is being made available in order to give
applicants some flexibility in planning / organizing prior to hosting events
during NVCAW. The maximum amount of funding that can be provided by the
Department of Justice Canada for NVCAW 2012, whether or not it spans more than
one fiscal year, is $10,000.
BUDGET FOR NVCAW 2012 PROJECT
| Fiscal Year 2011-2012 (Jan. 1, 2012 – Mar. 31, 2012) | Fiscal Year 2012-2013 (Apr. 1, 2012 – Apr. 14, 2012) | Total | |
|---|---|---|---|
| Department of Justice | |||
| Your organization | |||
| Other: | |||
| Total Revenues: |
| Fiscal Year 2011-2012 (Jan. 1, 2012 – Mar. 31, 2012) | Fiscal Year 2012-2013 (Apr. 1, 2012 – Apr. 30, 2012) | Total | |
|---|---|---|---|
| Total Expenses: |
Please indicate your organization’s GST/HST rebate (percentage) from the Canada Revenue Agency. %
Conditions
Departmental funding may be used only for the purposes specified in this application. Once the Department has agreed to provide financial assistance, no substantial change to the project shall be made without the consent of the Department, and it shall be at the discretion of the Department to determine what constitutes substantial change in each case. Any funding not used for these purposes must be returned to the Department.
The organization is wholly responsible for its own debts. The Department will not consider any application to pay debts. If any part of this funding is used to pay salaries, federal and provincial laws concerning salaries and source deductions must be applied (e.g. deductions for income tax, employment insurance, etc.).
Public acknowledgement of funding provided by the Department is required. The Department's financial assistance must be clearly acknowledged in any publications, written or print material produced as part of the project and/or during any public presentations. (E.g. We wish to acknowledge the funding that was provided by the Department of Justice Canada Victims Fund). The Department of Justice Canada logo is available for your use, as well as the NVCAW 2011 logo.
The organization agrees to respect and apply the spirit and, if applicable, the letter of the Canadian Human Rights Act and of the Official Languages Act.
In the event of an access to information request regarding the present funding application or any other information about the organization in the Department's possession, the organization will be consulted before any confidential information is disclosed. Under the Access to Information Act, there is provision for exemption from disclosure of personal information subject to the Privacy Act, and of confidential financial or business information. The designation PROTECTED (once this application form is completed) ensures that this information receives enhanced protection. When funding is approved, the amount of funding, the purpose for which the funds were granted and the name of the organization receiving the funding are considered public information.
I. the undersigned, declare that:
- the information in this application is accurate and complete;
- the application is made on behalf of the organization named on page three (3) with its full knowledge and consent;
- if financial assistance is provided, the organization will submit financial statements and activity reports as required by the Department of Justice Canada;
- if financial assistance is provided, the organization will submit to an evaluation of the project funded, as required by the Department of Justice Canada.
Name of organization:
Name of person with signing authority:
Position/Title: Date:
Please Note: The Department of Justice DOES NOT need a signed paper copy of this application. The submission of this application electronically to the Department is understood to be consent for the Department to review the application and to enter into a funding agreement with the organization, if funding is approved.
Annex A
National Victims of Crime Awareness Week 2012
Moving forward
The 7th annual National Victims of Crime Awareness Week (NVCAW) will be commemorated across Canada from April 22 – 28, 2012. The theme that has been chosen for NVCAW 2012 is Moving forward.
This theme recognizes:
- Victims: Being a victim of crime can be a life-altering experience. How an individual may chose to move their life forward after being victimized will be unique to the person and the situation. All victims deserve to be treated with compassion and respect for their dignity as they move forward on their journey toward healing.
- Government: Over the past 30 years, Canada has made significant advances in the area of victim of crime issues. By working with partners in the provinces and territories as well as with victim service providers, the Government has ensured that victims have a more effective voice in the criminal justice and corrections systems. Building on this momentum will help us move forward and continue to make meaningful change for victims of crime.
- Victim services: Throughout Canada, there are countless dedicated people who work with victims of crime everyday. Victim services and the professionals and volunteers who provide them, help victims of crime move forward after a victimization, maintain hope for the future and rebuild their lives.
Annex B
NVCAW 2012 Funding Application Checklist
Applicants must ensure that the following points have been addressed in their application, and that the applicable documents have been included as attachments in the email submission.
Selection Criteria:
- My application has been completed in full.
- My completed application, along with any required supporting documentation has been emailed to victimsweek-semainedesvictimes@justice.gc.ca at the Department of Justice Canada by November 7, 2011.
- All of the expenses that I have listed in my budget are eligible for funding, and I have consulted “How to Apply for Funding – A Guide to Preparing a Proposal” and the “FAQ” document included in the NVCAW 2012 funding package to confirm.
- I believe that all of the expenses listed in my budget are reasonable and customary, and demonstrate a good value for Canadians.
- The theme for NVCAW 2012 (Moving forward) is reflected in my proposed project.
- My proposed project supports the Victims Fund objective of raising awareness and knowledge about the impact of victimization, the needs of victims of crime, available services, assistance and legislation. I have attempted to work with partners in my community, and to make this project as collaborative as possible.
- I have attempted to work with partners in my community, and to make this project as collaborative as possible.
Additional Documents:
- If my organization is incorporated, I have attached a copy of the certificate and the articles of incorporation OR the letters patent to my email submission.
- If my organization is located in Québec, and I answered “yes” to any of the questions in Section 4, I have attached the Order in Council allowing my organization to negotiate and enter into an agreement with the Department of Justice Canada to my email submission.
- If I completed my project work plan in a separate document, I have included it in my email submission.
