Information about http://pch.gc.ca/progs/pec-csp/guide/2005/application_form_e.pdf

Canadian Patrimoine Heritage…

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Language: english
Created: Wed Aug 10 10:53:46 2005

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Canadian Patrimoine
Heritage canadien FUNDING APPLICATION PROTECTED when completed

INSTRUCTIONS
1. Please refer to the instructions on how to prepare your project proposal on the reverse.
2. Complete all sections, sign and date the form; please type or print responses.
3. Send the form and the project proposal to the Department of Canadian Heritage.

PART A - APPLICANT INFORMATION
ORGANIZATION
Name in Full Previous Name(s) of Organization

Scope of Organization's Activities Local Municipal Provincial / Territorial Regional National International

LEGAL STATUS In process
Yes Federal
Incorporated Corporate Registration No. Date applied
No Provincial / Territorial

Yes In process
Registered with Revenue Canada
as a Charitable Organization Registration No.
Date applied
No

CONTACT PERSON'S NAME Mr. Mrs. Miss Ms. Other

First Name Family Name Title

Office Tel. No. Residence Tel. No. Fax E-Mail
( ) ( ) ( )
INDIVIDUAL
Mr. Mrs. Miss Ms. Other
First Name Family Name
Canadian Citizen or Permanent Yes No
Resident / Landed Immigrant

APPLICANT'S ADDRESS
Street Address (City, Province, Postal Code) Mailing Address (if different)

Tel. No. Fax E-Mail Web site
( ) ( )
If yes, under what name and for what year? Date
Have you previously received funding
from the Department of Canadian Heritage Yes No

In which official language do you wish to communicate? English French

PART B - PROJECT SUMMARY INFORMATION
Main type of activity that describes your project

Project Title

Project Description

Proposed Start Date End Date

Amount requested from the
Total Cost for Project $ Department of Canadian Heritage $

Have you also applied to other Federal Departments or other If yes, please specify
No Yes
programs of the Department of Canadian Heritage?

PART C - AFFIRMATION

I AFFIRM THAT the information in this application is accurate and complete, and the project proposal, including plans and budgets are
fairly represented. I agree that once funding is provided, any change to the project proposal will require prior approval of the
Department. I agree to publicly acknowledge funding and assistance by the Department, where appropriate. I also agree to submit a
final report, and where required, financial accounting for evaluation of the activity funded by the Department. I understand that the
information provided in this application may be accessible under the Access to Information Act. I also agree to respect the spirit and
intent of the Canadian Multiculturalism Act, the Official Languages Act and the Canadian Charter of Rights and Freedom and
other human rights legislation.
SIGNING AUTHORITY

Authorized Signature Name and Title (please print) Date

OFFICE USE ONLY Date Received File No. Program Officer

(See instructions on reverse)
(Aussi disponible en fran�ais)

(08/2005) 7540-CH-902-0945-E
Part D: Canadian Studies Program

CHECKLIST
Before submitting your application, please ensure that you have completed the following tasks:

BEFORE APPLYING
1. Carefully read the Canadian Studies Program Applicants' Guide.
2. Discuss your project with a Canadian Studies Program Officer.

WHEN APPLYING
More detailed information on required documentation is presented in pages 8 to 10 of the Applicants' Guide.

SUMMARY CHECKLIST

Required documents, information or descriptions (4 copies of each are required) Included

1. Signed and completed Application Form.
2. An explanation of the applicant's eligibility.
3. A statement that only new content is being created.
4. A detailed description of the project, its intended users, objectives, scope, methodology and expected
results.
5. An explanation of the pan-Canada focus, application or importance of the project.
6. A description of how the project meets the first objective of the CSP (p. 4 of the Guide) and one or
more priority areas of the current Funding Competition (p. 5 of the Guide).
7. An explanation of potential general educational and/or pedagogical applications of the project,
including a description of how the project will be developed to meet the needs of educators and young
Canadians.
8. A description of how the learning/teachers' guide, if applicable, will be tested by the target audience(s)
prior to completion and how the Guide will address curricula requirements for different regions of the
country.
9. A description of how the final product will be developed in both official languages where appropriate
and be applicable to both official language groups whenever possible.
10. A statement that the online content developed will be available for a minimum period of three years
(for Web-based projects only).
11. A detailed budget of expenditures and sources of funding (including anticipated sales and in-kind
contributions if applicable), with a monthly or quarterly cash-flow forecast for the entire project, proof of
confirmed funding sources, a description of each budget item and a description of the budget items for
which CSP funding is requested.
12. A detailed project development timeline with key milestones for the entire project.
13. A clear marketing and distribution strategy for the final product to reach educators and young
Canadians.
14. A letter from a bona fide Canadian publisher showing intent to produce and distribute the manuscript
(for print learning materials only).
15. An appropriate follow-up strategy to measure the results (impact and reach) of the project for a
minimum period of three years after the project's completion.
16. A signed certification of agreement to the follow-up requirements (p. 13 of the Guide).

17. A minimum of two letters of support from experts in the field of the project.

18. The CVs of the principal project personnel and authors.
19. Proof of the legal status of the organization.
20. A list of the Board of Directors or Council members if applicable.
21. Proof of the signing authority of the contact individual if applicable.
22. An explanation that any former public office holder or public servant who is in the employment of the
applicant for the purposes of the project is in compliance with the Values and Ethics Code for the
Public Service, if applicable.
23. Copies of any examples of previous work done and/or reference materials if applicable.

CERTIFICATION

We certify that the information provided in this application is accurate and complete. We certify that, should project money be
provided by the Canadian Studies Program, it will be spent solely for the purposes indicated in this application.

We understand that the information provided in this application will be used for Program assessment purposes, and that both the
application and the assessment process are treated as confidential. If the project is funded, details of the project, including
information about the individuals mentioned in this application who are members of the organization or group in question, may be
used for public information notices or released under the Access to Information Act.

Authorized signature Name and Title (please Print) Date

(08/2005) 7540-CH-902-0945-E