Application Form - Pinecrest-Queensway Community Health Centre

APPLICATION FORM
Pinecrest-Queensway Community Health Centre's
CELEBRATION SEED GRANT AWARD
The Community Celebration Seed Fund was established in December 2014 through a donation made by a very
committed community supporter. The $25,000 fund is to provide one-time funding to celebrate initiatives that build
and strengthen the overall health and well-being of Pinecrest-Queensway residents and communities. Up to $5,000/
year may be awarded in amounts of up to $1,000/initiative.
The criteria for successful initiatives include:
· Client groups and/or resident involvement, and
· Activities that help to promote health and well-being, and
· Initiatives that would benefit from some additional one-time seed funding
Process for applications:
Attached is an application form to be completed and submitted to: c.rosenberger@pqchc.com. Applications are
invited throughout the year and will be reviewed quarterly (March, June, September and November). All applicants will
receive notification of the decision of their application once the review is completed.
Successful applicants will be advised and funding will be made available upon sign off of a `Conditions of Funding'
contract. This contract specifies the amount of funding that is provided and the intended use of these funds as outlined
in the application. Applicants will be invited to participate in a local funding announcement to help recognize, celebrate
and promote their project. They will also be invited to the Pinecrest-Queensway Community Health Centre Annual
General meeting (held in September of each year) to be recognized and celebrated for the projects that they are
involved with.
The 'Conditions of Funding' contract will also require that the applicant submit a summary of how the grant helped the
project. The details as to when this will be submitted will be determined based on the nature of the project in
consultation with the applicant(s).
Date
Celebration Seed
Grant Award
Title of Project
Contact Information
Name
Street Address
Email
City
Phone
Postal Code
Project Description
Description of client group(s)/resident involvement
How the Celebration Seed Grant will help to support the initiative
Please submit completed application to Coreen Rosenberger at c.rosenberger@pqchc.com.
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