Application for Funding
Communities at Risk: Security Infrastructure Program

This HTML copy of the application form is provided for reference purposes only and contains more questions than would otherwise be prompted through the online application platform. This reference version contains all possible questions for all circumstances.

Visit the Apply page to complete your application.

In which official language do you wish to communicate?

English / Anglais
Français / French

Section 1 of 7: Verify Your Eligibility

To verify if you meet the minimum criteria in order to qualify for funding, please confirm the current circumstances regarding your organization and the proposed project site in this section. All statements must be true to your circumstances in order to proceed with an application, with the exception of Question 1.4.

Successful completion of this section does not guarantee your eligibility for this program. Your eligibility will be confirmed by Public Safety Canada upon receipt of your application.

Q1.4: Has your organization been a direct victim of a severe hate-motivated crime in the last six (6) months which required the involvement of law enforcement?

Responding 'No' to this question does not prevent you from submitting an application. This question is to help determine whether your organization would better qualify for the SIP's Severe Hate-Motivated Incident Support (SHMIS) stream.

Yes
No

Q1.5: Please confirm that all the following statements apply to your organization:

All statements must be true in order to continue. An organization's primary mandate and activities constitutes the foundation of what an organization must accomplish to fulfill its vision and mission.

Your organization and/or project site:

Q1.6: Please confirm that your organization is:

Q1.7: Is your project site primarily considered as a:

Please note that your application will be assessed according to the category selected.

Q1.7a: You identified your project site as a Provincially/Territorially Recognized Private Educational Institution. Please confirm that all the following statements are true:

Your organization and/or project site (i.e. the recognized private school):

Please attach documentation that confirms that your private educational institution is recognized at the Provincial or Territorial level in the field below:

Failure to provide satisfactory evidence of provincial or territorial recognition will result in your application being deemed ineligible. To attach a file, select the upward arrow and follow the prompts.

Accepted Formats: .PDF, .JPG, and .PNG. Submissions using other formats will not be considered.

Q1.7b: You identified your project site as a Place of Worship. Please confirm that all the following statements are true:

Your organization and/or project site (i.e. the place of worship):

Please identify the type of place of worship:

Q1.7c: You identified your project site as a Community Centre. Please confirm that all the following statements are true:

Your organization and/or project site (i.e. the community centre):

As a community centre, please describe how your organization's gathering(s) fulfil the requirement of having "religious, spiritual or cultural significance":

Q1.8a: You identified your project site as a Gender-Based Violence (GBV) Shelter. Please confirm that the following statements are true:

Your organization and/or project site (i.e. the GBV shelter):

Q1.9: Is your project site considered as a primary stage support (temporary emergency shelter) or as a secondary stage support (transitional housing) in supporting individuals experiencing gender-based violence?

Q1.10: You indicated that your project site includes transitional housing. Please confirm that the following additional statements are true:

If the following statements related to your organization's second stage supports are not true but your organization also has an emergency shelter at the site, you may revise your response in Q1.7e to indicate only having a primary stage support at the project site. Note that only the emergency shelter portion of the facility would be covered as part of your project proposal.

Section 2 of 7: Applying Organization and Contact Information

Please provide information about your organization in this section. Ensure the information in this section is accurate and complete. This information is required in order to identify you as the applicant.

Section 2.1: Organization Identification

Please provide identifying information pertaining to your organization in this subsection.

Q2.1: Is this application being submitted on behalf of another organization?

Yes
No

If selected for funding, funds will only be distributed to the eligible organization who operates the project site. Please note that program funds may not be used to cover expenses related to the completion of this application.

Q2.1a: Please confirm the following:

Please complete this application form using only the information of the applying organization (i.e. the intended recipient).

Q2.2: Will your organization be financially capable of covering 50% of the costs for your project using non-government financial sources?

Your response will not impact your application for funding. Please note that funding under this program is generally provided in the form of reimbursement at the end of your project, covering up to 50% of eligible project costs. Organizations must ensure the necessary funds are available by the time an agreement is signed with the Department.

Yes
No

Please ensure that if your application is approved, funds are readily available to cover the costs for the entire duration of your project by the time you are asked to sign an agreement. If you have any concerns or questions, please contact the Program mailbox.

Q2.2a: As an authorized representative of the applying organization (i.e. intended beneficiary), please indicate whether your organization claims tax rebates:

Yes, the organization claims federal and/or provincial tax rebates.
No, I attest that the organization does not claim federal and provincial tax rebates.

Q2.3: Is your organization submitting more than one application under this Call for Applications (i.e. each for a different project site)?

Organizations are permitted to apply for more than one project site under the same Call for Applications. Each application will be evaluated individually.

Yes
No

Applications must be tailored and specific to each project site. Failure to do so may render your application ineligible.

Q2.4: Does your organization operate under a different name other than its legal name?

Yes
No

Please complete this application form using only the information of the applying organization (i.e. the intended recipient).

Q2.5: Organization's Operating Name:

Q2.6: Organization's Corporate Legal Name:

Make sure to include any capital/lower case letters, periods or commas that are part of the name. This will be used for verification purposes.

Organization's Address:

Street address:
Mailing address (if different than street address):
City/town:
Province/Territory:

Postal code (e.g. X1X 1X1):
Telephone number (e.g. 555-555-5555):
Website (If applicable):

Q2.8: Please briefly describe the mandate of your organization:

Q2.9: Please provide your organization's incorporation information:

Corporate Registry Identification:

Please indicate under which government authority your organization is primarily incorporated by.

A business in Canada can be incorporated federally or in the province or territory where it operates.

Business/Charity Number:

9-Digit GST/HST Number (if applicable):

Q2.10: Will the proposed project activities only take place at the organization address identified above?

The project site is the physical location where your organization intends to install the proposed security measures. Only one application may be submitted for each project site and each project site requires a separate application.

You identified your organization (including the project site) as operating in the province of Québec. If the project is selected for funding, please note that organizations based in Québec may need to provide their most recent audited financial statements prior to signing a funding agreement to ensure compliance with the requirements of the provincial Act M-30 - Respecting the Ministère du Conseil Exécutif.

Section 2.2: Additional Organization Information

Please provide some additional information regarding your organization in this sub-section.

Q2.11: Please identify the employment size of your organization:

Including staff and volunteers.

Q2.12: What is the average annual revenue of your organization?

Q2.13: Does your organization's staffing composition identify as any of the following:

Select all that apply.

Please explain (socio-economic status):

Please explain (educational level):

Please explain (familial characteristics):

Section 2.3: Designated Organizational Contact Information

Please provide the contact information for the individual who will serve as liaison for your organization with Public Safety Canada for the duration of the process. Only the Designated Organizational Contact will receive communications regarding this application. Should this contact change, please inform Public Safety Canada as soon as possible. Please be sure to check junk/spam folders regularly so communications are not missed.

Q2.13: Please identify the Designated Organizational Contact for this Application:

The designated organizational contact will be the primary contact point between Public Safety Canada and the organization in regards to this application. This contact will receive all information pertaining to the status of this application. Email is the default method of communication.

First Name:
Last Name:
Position/Title:
Daytime telephone (e.g. 555-555-5555):
Cell phone (optional) (e.g. 555-555-5555):
Email address:

Section 3 of 7: Project Site Information

Please provide more information about your project site in this section. The project site is the physical location where your organization intends to install the proposed security measures. Ensure the information in this section is accurate and complete.

Section 3.1: Project Site Location

Please identify the project site's location in this subsection. The project site is the physical location where your organization intends to install the proposed security measures.

You previously indicated that project activities will take place at your organization's address. Please note that your organization's address will be referred to as the 'project site' for this application. If your project site differs from the organization's address you identified earlier, please return to Section 2.1 to amend your response.

You previously identified your project site as a Gender-Based Violence Shelter. Public Safety Canada takes the security and confidentiality of these sites seriously. Information entered in this section, as well as your floorplans, will be handled as sensitive information and will remain confidential.

Q3.1: You previously indicated that project activities will not take place at your organization's address but would take place at a different address. Please confirm and identify the project site below:

Yes, project activities are occurring at a different address.

Please identify the project site:
The project site is the physical location where your organization intends to install the proposed security measures.

Project site's name:
Street address:
Mailing address (if different than street address):
City/Town:
Province/Territory:

Postal code: (e.g. X1X 1X1)

You identified your project site is located in the province of Québec. If the project is selected for funding, please note that organizations based in Québec may need to provide their most recent audited financial statements prior to signing a funding agreement to ensure compliance with the requirements of the provincial Act M-30 - Respecting the Ministère du Conseil Exécutif.

Section 3.2: Project Site Information

Please describe the project site in relation to its usage, age and other circumstances in this subsection.

Q3.3: In what decade was the facility at the project site constructed?

You have indicated the facility at your project site is under construction. A permanent building or structure is required to receive funding and install security enhancements. Please note that if construction is not at a point where security enhancements can be installed by the time your project is approved, Public Safety Canada may be unable to move forward with supporting your project.

Q3.4: Does the project site share its real-estate with other businesses or tenants besides your organization?

Yes
No

Please provide details regarding the other uses of the building (e.g. daycares, venue spaces, commercial shops etc.), including whether the spaces are shared or physically segmented, frequency of use for these purposes and who accesses the spaces (e.g. public, private members etc.)

Q3.5: Please enter the year (yyyy) your organization began operating and providing its services at the project site:

Q3.6: Do you have any physical security measures currently in place at your project site?

Yes
No

Please list and describe the physical security measures currently installed at your project site:

Section 3.3: Project Site Funding History

Please provide information on your project site's funding history as well as your organization's general funding history in this subsection.

Q3.7: Has this project site previously received and benefited from funding provided by the federal Security Infrastructure Program (SIP)?

Yes
No

Please identify the calendar year (yyyy) in which funding was provided (if known):

Please identify the file number associated with past SIP funding (if known):

Q3.8: Is this request for funding in order to undertake new project activities, or is it a request for funding for a continuation or next phase of a previously funded project?

New
Existing

Q3.9: Has your organization ever received funding from Federal Provincial/Territorial or Municipal governments?

Yes
No

Please identify which government(s) your organization have received funding from previously:

Please briefly describe your organization's previous publicly-funded project(s):

You may describe experience in developing, implementing, monitoring and managing projects (regardless of funding sources) within a specified timeframe and budget.

Q3.10: Has your organization applied, or intends on applying to another government program related to security infrastructure to support this project?

Please review program Terms and Conditions for more information on limitations.

You indicated that your organization received or is planning to receive government funding for security infrastructure. Please carefully review program Terms and Conditions for more information on limitations. At this time, organizations cannot use other government sources to fund their project for the same eligible expenses.

Section 4 of 7: Community Risk

Please demonstrate that your community and/or project site is at risk of being victimized by hate-motivated incident/crime in this section. This can include hate-motivated incidents/crime directly experienced at your project site (e.g. hateful graffiti).

Your organization's project site does not have to have been directly victimized by a hate-motivated incident/crime to be considered eligible for program funding.

Section 4 Additional Completion Requirements:

Section 4.1: Project Site Incident History

Please provide information regarding the prevalence of hate-motivated incidents at your project site in this subsection.

Q4.1: Has your project site ever experienced a hate-motivated incident/crime?

Your project site does not have to have been directly victimized to be considered eligible for program funding. This helps the Department prioritize funding.

Q4.2: Please identify the time frame in which your project site most recently experienced a hate-motivated incident/crime:

Q4.3: Has your project site been the target of a hate-motivated incident on more than one occasion?

Yes
No

Q4.4: Was there police involvement in regards to the hate incident?

Your response will not impact your application for funding.

Direct Incident(s) Against the Project Site

You indicated that a hate-motivated incident/crime occurred at your project site. Please provide supporting documentation regarding the event at your site.

A minimum of one (1) supporting document that demonstrates at least one hate-motivated incident/crime occurred is required in order for your project to be prioritized. Examples of supporting documentation can include police reports, media reports, and photographs, which demonstrate a hate-motivated incident/crime occurred at your project site.

Please attach supporting documentation below:
Accepted Formats: .PDF, .RTF, .JPG, .PNG and Microsoft Word (.DOC and .DOCX). Submissions using other formats will not be considered.

Q4.5: Please specify the type(s) of hate incident/crime your organization has experienced:

Select all that apply.

Q4.6: Do you need to attach additional documents? (Optional)

Yes
No

Please attach any additional supporting documentation:

Q4.7: Please briefly describe the contents of all documents submitted in this section and how they illustrate that your project site was a victim of a hate-motivated incident/crime. We encourage you, if possible, to provide additional detail on the events that took place.

Section 4.2: Community Threats and Vulnerabilities

Please identify the particular threats and vulnerabilities present at your project site and should clearly demonstrate your risk of being victimized by hate-motivated crime/incidents in this subsection. Although not required, a professional security assessment can help you identify the specific threats and vulnerabilities and how they could be addressed.

Threats

Please identify the specific threat(s) which pose(s) a concern to your organization's project site. For the purpose of this program, a threat is an event that has the potential for negatively affecting the project site and those who occupy the space. For example, an organization may face a threat of hateful graffiti being sprayed on their facility's walls.

Q4.8: What are the threats to your project site and/or people engaged within it which you believe to be of greatest concern?

Please focus and elaborate on specific types of threatening situations such as vandalism, bodily harm, breaking and entering, theft, etc. in which your organization fears could occur.

Vulnerabilities

Please identify specific vulnerabilities at your project site which pose a security concern for your organization. For the purposes of this program, vulnerabilities are the gaps or weaknesses that undermine an organization's safety and security. A threat will exploit a vulnerability in order to inflict harm. For example, a lack of surveillance cameras and anti-graffiti spray on the facility walls will leave the facility especially vulnerable to the threat of hateful graffiti.

Q4.9: Considering the threats you've outlined above, what do you believe to be your three most significant vulnerabilities?

Your project will need to work towards addressing some or all vulnerabilities you identify in this section. For example, a lack of surveillance, no locked doors, and inadequate protection of the public entering and exiting the facility etc. You may provide your answer in bullet form.

Q4.10: At what point in time do you consider yourself to be most vulnerable?

For example, during a service or specific operating hours, overnight, a specific holiday etc. You may provide your answer in bullet form.

Q4.11: Have you completed a security assessment for your project site in the last year?

Yes
No

Please attach a copy of your security assessment (Optional):
Accepted Formats: .PDF, .RTF, and Microsoft Word (.DOC and .DOCX). Submissions using other formats will not be considered.

You indicated that a security assessment has not been recently completed for your project site. Please note that a recent Crime Prevention Through Environmental Design (CPTED) security assessment will be required only if your project proposal involves any landscaping activities. Please consult the SIP Application Guide for more information.

Section 4.3: Community Support

Please provide one (1) Letter of Support provided and signed by a member of the community . The letter from your community should show support for your proposed security project and/or acknowledge existing security challenges at your site in order to be considered for funding. A letter template is available for your convenience.

The letter cannot originate from the applying organization or its own staff. For more information, we encourage you to review the SIP Application Guide to ensure your letters are acceptable and avoid conflicts of interest. Failure to provide a letter of support which meets our requirements as part of your application will render your application ineligible.

Please attach your Letter of Support:
Accepted Formats: .PDF, .RTF, .JPG, .PNG and Microsoft Word (.DOC and .DOCX). Submissions using other formats will not be considered.

Section 5 of 7: Project Activities, Work Plan and Financials

Please describe in this section your project activities and protection measures which will be addressing the vulnerabilities you previously identified throughout Section 4. In addition, you will be asked to outline project activities and associated costs through your work plan, quotes and your budget. Please refer to the SIP Application Guide for additional guidance.

Section 5 Additional Completion Requirements:

Section 5.1: General Project Activities

In this subsection, you are asked to describe your project in terms of general activities and how it relates to the threats you have identified. Your project should work to mitigate the risks from these threats by implementing specific protection measures to address the security vulnerabilities at your project site.

Q5.1: Based on the threats and vulnerabilities you identified in Section 4.2, what protection measures are you proposing to put in place and how will they work to address these vulnerabilities and ultimately fulfill the program's objectives ?

In this question, please ensure to describe the overall scope of your project.

Q5.2: Briefly explain how will your organization's project meet the needs of the community members it serves?

Q5.3: Does your project include training for staff and volunteers on responding to a hate-motivated incident?

Yes
No

Q5.4: Please describe in detail what the training entails and how it relates to responding to (or preventing) hate-motivated incidents:

Section 5.2: Work Plan

In the table below, outline your project activities and protection measures and how they will be addressing the vulnerabilities you previously identified throughout Section 4. We strongly encourage that you review the contents of the SIP Application Guide for proper completion of this section.

Work Plan

Instructions:

For additional guidance and a visual example of a completed work plan, please refer to the SIP Application Guide. Use as many rows as necessary.

Example of a work plan

Project Activity (up to 15)

Installation Location

Security Objective
Project Activity 1
Project Activity 2
Project Activity 3

Q5.5: Does your organization have a plan to routinely maintain the physical security equipment proposed in your work plan?

Yes
No

Please note that the program does not cover costs associated with the maintenance of security equipment. Maintenance of the installed physical security equipment is the responsibility of the organization. Given the critical role the equipment will play to increase safety of your building, we strongly encourage your organization develop an appropriate plan to ensure the longevity and optimal performance of the equipment.

Q5.6 Does your project include any activities which require a permit or additional consultations (e.g. minor renovations, window film, vehicle gates, fencing, electrical work)?

Yes
No

Please note that it is the responsibility of the applicant to ensure they obtain all necessary permits and conduct the necessary consultations required to realize their project and be in compliance with local, provincial and federal laws and building codes. Note that your local fire department should be consulted if the project includes window film or equipment which impacts vehicle access (e.g. vehicle gates) to prevent possible issues during emergencies.

Section 5.3: Project Layout

Please provide floorplans which include a detailed visual overview of where your physical protection measures are proposed to be placed/installed both in the interior and exterior in this subsection.

Failure to provide a floorplan which meets our requirements as part of your application may render your application ineligible.

For helpful information on floorplan requirements, please consult the SIP Application Guide.

Important Reminders:

In section 3.2, you previously indicated that your project site is shared with other tenants and/or businesses. Please ensure the spaces used by your organization are clearly discernable in your floorplans.

Please provide an exterior/interior floor plan for the project site outlining the proposed protection measures:
Accepted Formats: .PDF, .RTF, .JPG, .JPEG, .IMG, .PNG, .BMP and Microsoft Word (.DOC and .DOCX).

Submissions using other formats or of insufficient resolution to be legible will not be considered.

Q5.7: Do you need to attach additional floorplan-related documents (Optional)?

Yes
No

Please attach any supplemental documentation such as photographs illustrating where the proposed security equipment will be installed (optional, up to five (5)):

Section 5.4: Project Estimates

Please submit quotations (i.e. quotes/cost estimates) for the project activities and/or protection measures identified in your Work Plan (Section 5.2) in this subsection.

Before you begin this section:

If submitting more than one chosen quote, ensure all the proposed project activities and protection measures (i.e. training, labour, security equipment etc.) mentioned in your Work Plan (Section 5.2) are included. Project activities and/or protection measures listed in your Work Plan and Budget which do not have an associated quote will not be considered for funding.

Proactive submission of comparable quotes or price certifications is optional but strongly encouraged. Comparable quotes are quotes you obtained for similar services but decided to go with another vendor (chosen quote). As part of normal best practice whenever undertaking an infrastructure project, interested organizations should work to obtain quotes from multiple potential vendors to ensure they receive the best value for money, quality service, and trustworthiness of the vendor(s). This practice is expected to be undertaken by all who apply. Please note that the Department reserves the right to request comparable quotes or price certifications at any time during the process.

You previously indicated in your application that your project activities will include training on how to respond to a hate-motivated incident.

Please note that the training's quote must be from a certified security professional or other reasonably qualified person(s) on the company/consultant's official letterhead. The quote must include:

A detailed curriculum will be requested at a later time to ensure it fits with the program objectives as defined in the SIP Terms and Conditions.

Quote 1

Please attach a quote for your project:

Please ensure your quote includes vendor's official letterhead, legal business name, complete business address, province/territory and GST/HST tax information.

Q5.8: Please provide the following information regarding Quote #1:

Chosen Quote
Vendor Corporate (Legal) Name:
Vendor (Operating) Name:
Province/Territory:
Business Number:
GST/HST Number (9 digits):
Project Activities Involved:

Q5.9: Does your project involve more than one vendor to complete your project?

Ensure you have submitted quotes representing all project activities and protection measures you identified in your Work Plan (Section 5.2).

Missing project activities/protection measures will not be considered for funding.

Yes
No

Q5.9a: Would you like to proactively submit comparable quotes?

The submission of comparable quotes is optional but strongly recommended. Public Safety Canada may request that you obtain and submit comparable quotes at any time during the process.

Yes
No

Ensure to identify each quote appropriately as either a "chosen quote" or as a "comparable quote" using the drop-down menu options in the following sections.

Q5.10: How many additional quotes would you like to submit?

A maximum of 8 additional quotes may be submitted.

Section 5.5: Overall Project Financials

Please attach the completed mandatory budget template as well as report on the project's estimated cost for an official funding request in this subsection.

Project Budget

Please attach the mandatory budget template. For further information or to download the template, please review the Instructions for completing the Budget Template. The expense items listed in the budget template must match the items listed in your chosen quotes. Please note that you are required to submit a completed and detailed budget using the mandatory template with your online application. Failure to provide a budget using this template will result in an incomplete application.

Please attach your completed mandatory budget template:

Accepted Formats: .XLSX. Your budget must be submitted using the mandatory budget template. Submissions using other formats will not be considered.

Please provide your organization's tax rebate information:

Please enter the percentages you used for the green boxes within the budget's tax tool. Please use a zero (0) if not applicable to your organization.

Federal (GST) Tax Rebate (%):

Provincial Tax Rebate Percentage (%):

Federal Funding Request

In this subsection, you are asked to indicate the overall project cost and how it will be cost-shared between Public Safety Canada and your organization. This subsection is where you will make your official request for a given amount of funding under the SIP. Your funding request must match what was calculated in your Budget. Please carefully review and ensure your budget calculations are accurate and contain no flagged errors. Requested items must fit within the program's Terms and Conditions. Your project costs should be based solely on the quote(s) from your chosen vendor(s).

The Department will require all recipients of contributions to disclose all sources of funding for a proposed project before the start and at the end of a project. Funding cannot be used in combination with any other federal/provincial/territorial/regional/municipal government assistance for the same purpose and eligible expenses.

Q5.19: Please enter project costs information below:

Please report on the exact amounts calculated in the summary section of the mandatory budget template only.

1 - Physical Security Enhancement Equipment:
2 - Minor Renovations and Supplementary Equipment:
3 - Planning:
4 - Training:
5 - Eligible Taxes:

Total cost of project:

Federal funding requested:

Please note that your requested funding amount is not guaranteed to be granted in full if your application is approved.

Section 6 of 7: Demographic Information

Please provide information regarding the communities your organization serves and/or represents in this section. Information provided in this section is for statistical purposes only and will not impact your application. However, completion of this section is mandatory. Should you have questions about this section, please refer to the SIP Application Guide or contact the Program mailbox

Please provide information regarding the demographics of the population your organization represents.

Q6.1 Your community feels most vulnerable to hate crimes motivated by:

Please select one:

Q6.2 Please identify the most commonly used language(s) by the population serviced by your organization at the project site:

Please select only those that specifically apply to your project site.

Please specify the language(s) used:

Q6.3 Please identity up to four (4) demographical categories that best describe or are the most applicable to your organization (at the project site). In particular, this proposal is primarily designed to benefit:

Please select only those that specifically apply to your project site.

Please explain (optional | 1-2 sentences):
Exceptionally, if none of the options above can adequately reflect the intended group of the proposal, please use this explanatory box to provide further details.

Q6.4 Which race(s), nationality(ies) or ethnic group(s) does your organization (at the project site) best identify with? Please specify up to four (4):

Please select only those that specifically apply to your project site.

Please specify:

Q6.5 Which religious or spiritual belief does your organization (at the project site) best identify with? Please select one (1) of the options:

Please select the one that specifically applies to your project site.

Please specify:

Q6.6 You selected 'Indigenous Peoples', please select all that apply:

Please select only those that specifically apply to your project site.

Q6.7 Does your organization (at the project site) identify itself as part of the 2SLGBTQI+ community?

Q6.8 You selected 'Newcomers and Immigrants', please select all that apply:

Please select only those that specifically apply to your project site.

Q6.9 Classification of Immigration Status:

Please select only those that specifically apply to your project site.

Section 7 of 7: Disclosures and Feedback

Please disclose information pertaining to debts, official language requirements and potential conflict of interests in this section. You may also provide feedback on this application process and include any additional details or special circumstances you would like us to know about your application.

We sincerely appreciate you taking the time to complete this section as accurately as possible to support this important work.

Section 7.1: Declarations and Disclosures

Please disclose pertinent information regarding potential or known conflicts of interest as it relates to this application in this subsection. You are also asked to declare any current outstanding debts to the crown and how your project will respect the Official Languages Act.

Q7.1: Does your organization have outstanding amounts owing to the Government of Canada?

Answering yes to this question will not invalidate your application.

Yes
No

Please indicate the total amount owing ($):

Please provide the name of the department or agency it is owed to:

Q7.2: Will this project include the services of a current or former Federal public servant either as an employee or as a member of the Board of Directors or advisory committee?

Yes
No

Please describe their role and provide assurance that the public servant (or former public servant) is in compliance with the Values and Ethics Code for the Public Sector, and the Conflict of Interest Act (S.C. 2006, c.9) or the Parliament of Canada Act (R.S. 1985, c.P-1.01):

Q7.3: Will this project include the services of a lobbyist?

Yes
No

Please provide assurance that, where lobbyists are used, they are registered in accordance with the Lobbying Act (R.S.C., 1985, c44 (4th supp.)) and that no commissions or contingency fees have or will be paid directly or indirectly to any person for negotiating or securing this request for funding:

Q7.4: Will the project have an impact on Official Language Minority Communities (OLMCs) and does the project offer an opportunity to foster the full recognition and use of English and French in Canadian Society?

Yes
No

Describe how the needs of the official language group (anglophone/francophone) will be addressed. If there are none to be considered, provide a rationale as to why:

Section 7.2: Feedback

In this subsection, you are given the opportunity to provide any feedback on this application tool, our resources and processes. You are also provided with the opportunity to add any additional information which you feel may be necessary in regards to your application for funding.

Q7.6: Would you like to provide any feedback with regards to this application tool (i.e. understanding, technology, questions, length, user-friendliness etc.), other resources or the process?

Yes
No

Thank you for taking the time to provide feedback. Please provide your feedback below:

Q7.7: Is there anything else you would like to tell us about your project, your present circumstances, or have us consider as part of the assessment of your application?

Information provided in this question is supplementary and is not guaranteed to impact our decision on funding your project proposal.

Yes
No

Please provide additional information below:

Application Signature

You previously indicated that your organization is applying on behalf of the applying organization (the intended recipient). Please ensure that the applying organization has reviewed this section and authorized the submission of this application on their behalf.

As a representative of the organization submitting on behalf of the applying organization named in Section 2 of this application, I declare that:

As a representative of the organization named below, I declare that:

And understand that:

Please contact Public Safety Canada for further information should you have any concerns.

Q8.1: Declaration:

By submitting this application, I agree to the above and confirm that the submitted information is intended to support my application for funding under the Communities at Risk: Security Infrastructure Program (SIP) and that the information contained in this application is true, accurate and complete to the best of my knowledge.

Q8.2: Application Submitted by:

Name:
Title:
Organization Name:
Email Address:
Email Address (confirm):
Date (dd/mm/yyyy):

Date modified: