1. Print out the blank Acrobat/PDF version of the form and fill in the form by hand.
   
   OR
   
   
2. Save the blank Acrobat/PDF version of the form to your computer and complete the form on your computer. You cannot save a completed copy of the form on your computer. You must fill in the form and print it out at one sitting.
   
   OR
   
   
3. Save the blank MS Word version of the form to your computer and complete the form on your computer.
   
   
4. Send the signed and dated Application Form (with other required documents) by mail to the nearest Status of Women Canada office.

18) Organization's contact information

Organization's Street Address





Organization's Mailing Address (if different)

Telephone:

E-mail:

Fax no.:

Website:

20) a. Has(ve) the partner(s) committed to providing matching funding?

__ Yes        __ No

b. Written documentation submitted confirming intent to provide
matching funding?

__ Yes        __ No

21) Information about matching funds

In total, how much have you received in matching funds?

$ ____________________

Cash amount received

$ ____________________

Value of "in-kind" contribution received

$ ____________________

22) Source of Matching Funds

23) Provide the following information regarding the organization(s) providing matching funds (if more than one source of funding include the information on a separate sheet)

Organization

Name and Title of Contact Person

Tel. No.

E-mail

Please attach a preliminary proposal (maximum 6 pages, not including attachments) providing the following mandatory information (see attached glossary for definitions of key terms).

The Organization

(See Funding Guidelines for more specific information concerning eligibility requirements.)

• Describe your organization's mandate, membership, objectives and main activities.
• Describe how these support the Women's Program objective and reflect the Canadian Charter of Rights and Freedoms.
• Not-for-profit organizations: Describe the ways in which the organization functions democratically and demonstrates good governance.
• For-profit organizations: Describe the primary business and corporate structure.

The Project

• Describe the issue to be addressed, the primary group of women affected by the issue and how the need for the project was identified.
• Identify the partner(s), describe how they have been involved to date and their expected roles throughout the project.
• Describe how the project will involve the women most affected by the issue in the development and implementation of the project.
• What is the goal of this project?
• What are the project's objectives?
• Describe how the proposed project is aligned with the Women's Program funding priorities and those of the partner(s).
• Describe how this project will contribute to the Women's Program objective and outcomes as well as those of the partner(s) (see Funding Guidelines for detailed information concerning Women's Program objective and expected outcomes).
• Describe the key activities to be carried out and the timelines.
• What are the direct and measurable expected short term, intermediate and long term outcomes of the proposed project. The outcomes must show direct impact on women in their communities. (See attached Examples of Eligible Activities and Sample Outcome Statements.)

Budget

(See Funding Guidelines and attached Description of Budget Categories for more detailed information concerning eligible budget categories and funding levels.)
SWC does not provide funding to cover on-going administration costs or core funding. Matching funds are normally on a 1:1 ratio to the funds requested from the Women's Partnership Fund. Up to 25% of the matching funds can be in the form of "in-kind" contribution. Provide a preliminary budget for the project including the level of matching funds that are expected from all partners. Please use the attached Financial Information template.

• For a multi-year project (more than 18 months), complete a budget for each year of the project timeline as well as a cumulative budget for the entire project.
• Include "in-kind" contributions from your organization and others for the project, valued at reasonable commercial market values.

References

Provide the name, title, organization and phone number of at least two references that we can consult about this project and your organization.

The Organization's:

• Eligibility
  
  
  
  
  
  
  
  
• Capacity

• Whether the applicant organization's mandate and objectives support the Women's Program objective and reflect the Canadian Charter of Rights and Freedoms.
• Whether the organization functions democratically and practices responsible governance.
• Whether the organization is financially and administratively stable and can manage human resources.
• Whether the funding history with the Women's Program or other funding sources demonstrates accountability for funds and successful completion of projects.
• The organization's knowledge of the issue, its ability to implement the project, carry out the evaluation and report on the outcomes.
• The extent to which the organization leverages resources and builds partnerships through its work with public institutions and other stakeholders.

The Project's:

• Alignment
  
  
  
  
  
  
• Expected Results
  
  
  
  
  
  
  

• Feasibility/Effectiveness

• The extent to which the proposed project is aligned with government of Canada/SWC funding priorities.
• Whether the proposed project addresses one or more of the priority issues identified for 2007-2008.
• How the proposed project will contribute to the improvement of women's economic, social and cultural situation.
• Whether the proposal identifies clear, realistic and measurable outcomes to be achieved through the project and demonstrates clearly how these outcomes will impact women directly.
• The feasibility and effectiveness of the project in terms of the proposed activities, expected outcomes, timelines and potential risks.
• The level and nature of collaboration among the partners to date.
• The level and nature of collaboration among the partners that is expected to occur throughout the project.
• The extent to which women affected by the issue are directly involved in all aspects of the project.

Project Budget

• The level of funding requested from Women's Program.
• The level of matching funds that have been committed by one or more partners.
  
• The eligibility of the items and activities for which the organization is requesting funding from Women's Program.
• Whether the project budget is realistic in view of the proposed activities and expected outcomes.
• Whether the amounts requested in all budgets lines are consistent with local norms.

Activities that equip women to be able to participate more effectively in the economic, social and cultural life of their communities

• outreach
• peer support groups
• mentoring
• information workshops
• training
• resource development

• At least 100 women are enabled to address personal barriers that negatively impact their economic, social and cultural situation.
• Approximately 400 women have developed the knowledge and ability to access the resources, programs and services that will enhance their education and employment opportunities;
• At least 35 women have entered training programs or will be employed in non-traditional occupations;
• Approximately 100 women have increased their knowledge enabling them to take action to prevent violence against them;
• Approximately 40 abused women will have increased their ability to access existing resources, programs and services
• A minimum of 15 women have increased leadership skills and enhanced participation in their communities, families and key institutions.
  

Activities that enhance existing programs and services or that test new and innovative approaches to providing programs and services that are aimed at eliminating barriers to women's participation in the economic, social and cultural life of their communities

In collaboration with women, community partners, government and workplaces:

• develop and share best practices;
• assist women in identifying barriers to their participation;
• establish partnerships with decision-makers;
• develop and test models and pilot projects;
• carry out feasibility studies;
• develop culturally appropriate tools, workshops and other public education resources and approaches to educate communities concerning violence against women and girls;
• engage participants in implementing solutions to equality challenges

• Ten women's CED organizations have increased their ability to access capital from public and private lending institutions;
• Culturally appropriate programs in six communities that address family violence have been developed, demonstrated and evaluated;
• At least 40 women (abused or at risk) have participated in developing tools, resources and services in the area of violence against women by providing their knowledge;
• Three pilots involving targeted women's participation have tested the effectiveness of a new approach to program/service delivery and the models have been improved and implemented;
• These models have been shared with 10 organizations that plan to use them.

Financial contribution from other federal programs (provide details)

Financial contribution from provincial programs (provide details)

Financial contribution from municipal programs (provide details)

Financial contribution from private or corporate donation (provide details)

In-kind contributions from external sources (provide details)

Other (provide details)