AFRICAN NOVA SCOTIAN AFFAIRS Grants and Contributions Program Application Package Tier 2
ANSA Grants and Contributions Program- Application Package, Tier 2 Table of Contents 1. Information Sheet 3 2. Application Form 4 3. Evaluation Plan 6 3. Budget Overview 7 4. Declaration Form 7 5. Post Event Report 8 6. Reminder Checklist 8 To find out more about ANSA and the grant program, please see our website at http://ansa.novascotia.ca/grant or call (902) 424-5555. Page 2 of 8
1. Grants and Contributions Program Information for Tier 2 One of ANSA s goals is to encourage and support the community by assisting them to develop their organizational capacity. We attempt to offer this support in a number of ways; one of which is through our Grants and Contributions Program. The Grants and Contributions Program has limited funds, has been revised and reorganized. We try to ensure that African Nova Scotian groups from all parts of the province have the opportunity to access the program. Grants can be given to projects, programs, and activities that support ANSA s strategic goals in the following ways: Demonstrate a need for organizational development Foster collaboration between African Nova Scotian community organizations Address a documented need or issue Justify a benefit to the community In order to help community groups access resources most efficiently and effectively, ANSA has revised its grant program into a tier system. Below is information and the application package for Tier 2. Note that ANSA cannot review incomplete applications.. Tier 2: For funding up to $1,000.00 Requirements for this level include: A letter of request clearly stating the purpose of funds Completed Application Form Evaluation Plan Completed Declaration Form A letter of recommendation from a community member or organization Budget Overview Post event report given to ANSA (submitted within 60 days after event. please note: failure to submit will disqualify applicant for subsequent year) *Community groups can apply for this level of funding yearly. However, groups that receive funding for two consecutive years may not be considered in the third year. Page 3 of 8
ANSA Grants contributions Application Form: Tier 2 The Office of African Nova Scotia Affairs will manage all information collected on this form in accordance with Section 1.11 of the Grants and Contributions Information Package and in accordance with the Freedom of Information and Protection of Privacy Act. 2. Application Form Organization Name: Registry of Joint Stock Number (if applicable): Year organization was founded: Address: Telephone Number: Fax Number: Email Address: Website: Director/Chairperson: Contact person and title (if not Director): Project/Event Title: Location of Event: Project/Event start date: Project/Event End Date: Amount requested: $ (Maximum $1,000.00) Total Project Budget: $ Besides funding, what else is expected of ANSA? Brief summary of the organization s mission Page 4 of 8
Summary of Project/Event and how it links to ANSA s strategic goals: Give an example of an event you have completed: Have you contacted other departments or organizations for financial or in-kind contributions? (If yes, which ones): Please give a concrete example of how the community will benefit from this event/program? Page 5 of 8
3. Evaluation Plan Evaluation is a way of measuring if a project, program, or activity is doing what it says it will do. Data or information is collected to provide evidence about what is happening in the project, program, or activity (outcomes), why it is happening, and how things may be improved. This evidence can then be used to make judgments about the project, program, or activity s impact. For example, an evaluation plan will help answer the question How will you know if you have achieved the objectives of your project, program, or activity? Possible ways to answer the question: Track the number of community members who will be served by this program. Compile the number, type of presentations, workshops, articles, papers, resource materials produced at the end of this project, program, or activity. Document any changes that will be accomplished or achieved as a result of the project, program, or activity (outcomes). Outcomes provide a benefit (or consequence) for a target group, including change in knowledge, attitudes, skills, behaviour, or improvement to conditions or circumstances of individuals that participate in the project, program, or activity. Your evaluation plan should: Briefly describe your plan for evaluating the success of the project, program or activity or for your organization s work; Set out who will be involved in evaluating this work staff, board, community, stakeholders; Set out how and when will data be collected for example, surveys, interviews, questionnaires; and Set out how your results will be shared. Page 6 of 8
4. Budget Overview: Please give a brief overview of your budget. 4. Declaration Form We declare the information in this application and all attachments is accurate and complete, and that this funding grant application is being made by the organization named in this application package with its full knowledge and consent. We further declare if requested the group or organization will provide financial and activity reports that the Office of African Nova Scotian Affairs requires, such as interim and final reports. List of Board of Directors Name Position Address Telephone Authorization This application must be signed by two authorized representatives, one must be a designated signing officer of the Board of Directors: Application prepared by: Signature Print Name Date Board Authorization: Signature Print Name Date Page 7 of 8
5. Post Event Report: Please give a brief overview (No more than 3 pages) How the Money was spent: Breakdown of the budget to show revenues (in-kind & cash) and expenses related to the project/event. In addition: - Number of persons in attendance - Location of event - Copy of promotional material (if any) - Brief commentary on outcome(s) - What made the event successful? - What to do to improve for next time? This report must be submitted within 60 days after event. Failure to submit report will affect future applications. 6. Reminder Checklist PLEASE NOTE: Incomplete submissions may not be processed or will delay the review of applications. Have you enclosed the following items? SIGNED Request Letter Completed and SIGNED Application SIGNED Letter of Support from community organization Budget Overview SIGNED declaration Return completed Application* and all required documents by fax, mail or email (scanned) to: ANSA Grants Contribution African Nova Scotian Affairs 1741 Brunswick Street, 3 rd Floor PO Box 456, STN Central Halifax, NS B3J 2R5 Phone: (902) 424-5555 Fax: (902) 424-7189 E-mail: Josephine.Tommy@novascotia.ca *We may not be able to fund all applications received we appreciate the interest of community groups and recognize the valuable contribution each volunteers makes. Page 8 of 8