Application Form
Grants and Contributions Program to National Voluntary Organizations (GCP NVO)

Contribution Stream

 Application Form (Word 676 KB)

• Applicants are encouraged to use the word version of the Application Form to submit their proposals, however if an applicant does not have access to Word, the application questions have been posted separately below.
• The application form must be completed in full and signed.
• Responses in this form should use Calibri, size 11 font.
• There are 14 sections for the organization to complete.

Section 1: Organization Information

1. Preferred language of correspondence: English / French
2. 1. Legal name of organization:
   2. Legal name of organization in French (if applicable):
   3. Operating name of organization (if different from legal name):
   4. Type of organization:
   5. Official website address of organization:
3. Full mailing address, telephone number and general e-mail address of organization:
4. Courier address (if different than above):
5. Name of project contact person, position title and contact information:
6. Name of Authorized Signing Officer, position title and contact information (if different than above):
7. Incorporation Number/CRA/Indigenous Registration Number:
8. Date of Incorporation:
9. Size of organization
   1. Number of employees:
   2. Annual budget:
10. If the organization is located in the province of Quebec, refer to the Act Respecting the Ministère du Conseil Exécutif found on the Secrétariat aux affaires intergouvernementales Canadiennes site. Indicate whether your organization corresponds to one of the following categories defined in Section 3.6.2 of the Act:
    • Municipal body Yes / No
    • School body Yes / No
    • Public body Yes / No

Section 2: Amounts Owing to the Government of Canada

1. Does the organization owe any monies to the Government of Canada? Yes / No

   If yes, complete the following (repeat as necessary):
   Amount owing: ($)
   Nature of the amount owed (taxes, penalties, overpayments):
   Name of Government of Canada department or agency to which the amount is owed:

Section 3: Previous Funding

1. Has the organization received funding from the Government of Canada (grants or contributions) within the past 12 months? Yes / No

   If yes, complete the following for each project (inserting additional rows as needed):

   Note: The list below may be used as a reference check.

   Name of the Government Department and Funding Program:
   Contact:
   Title:
   Telephone number:
   E-mail address:
   Project start date:
   Project end date:
   Amount: $
   Project title:

Section 4: Overview of Project

Project title:
Project duration (in months):
Proposed start date:
Proposed end date:
Total project value (CAD$):
Total Public Safety Canada funding (CAD$):

Funding can be used to deliver direct support services to individuals with criminal records looking to apply to the Parole Board of Canada for a record suspension (pardon). Please indicate which initiatives/activities will be included in the organization's proposed project.

Program objectives

The organization acknowledges that the proposed project will:

• Contribute to the development of criminal justice policies and/or delivery of services; and
• Create or expand application support services for individuals with criminal records looking to apply for a record suspension (pardon).

Call priorities

The organization acknowledges that the proposed project meets the following priorities for the Program:

• The project will use funding to deliver direct support services to individuals with criminal records looking to apply to the Parole Board of Canada for a record suspension (pardon);
• The project will contribute to improved and more cost-effective programs or service delivery mechanisms; and
• The project will support public policy issues of strategic importance (e.g. reintegration).

Priority may be given to proposals that are able to meet the unique needs of distinct groups of people or unique services that would be beneficial in the completion of an application for record suspension (pardons).

Section 5: Organizational Overview

1. Describe the organization's mandate, objectives and key activities. Explain how they are related to the Public Safety Canada's mandate and objectives.
2. Describe how the organization's objectives and activities may lead to the achievement of the GCP NVO's expected results.
3. Describe the organization's governance structure. List the name and title of each Board member if applicable.
4. Describe the organization's internal accountability measures.

Assessment Criteria:

• Degree to which the organization's objectives and activities directly relate to those of the Department and its portfolio partners.
• Degree to which the organization has a suitable governance structure.
• Degree to which the organization has clear and defined internal accountability measures in place.

Section 6: Project Approach

1. Describe how the project will use funding to deliver direct support services to individuals with criminal records looking to apply to the Parole Board of Canada for a record suspension (pardon).
2. Describe how the project will contribute to improved and more cost-effective programs or service delivery mechanisms.
3. Describe the monitoring plan the recipient will undertake to evaluate project activities and outcomes on a regular basis.
4. Describe how the project will respect the spirit and intent of the Official Languages Act.

Assessment Criteria:

• Degree to which existing capacity is clearly described, and appropriate to the identified issue/need.
• Degree to which required additional capacity is clearly described, and appropriate to the identified issue/need.
• Degree to which the proposed project evaluation will effectively monitor project milestones and outcomes.
• Degree to which the Official Languages Act has been accounted for in the project.

Section 7: Organization Suitability

1. Describe why the organization is well-suited to undertake the proposed project. This may include, but is not limited to: relevant skills, past experience, established partnerships and educational awareness. The suitability of partners, and their specific contributions to successful completion of proposed capacity building activities, may be considered here as well.
2. Briefly describe the organization's key roles and responsibilities in carrying out the proposed project activities. If partners on this application also hold key roles and responsibilities, briefly describe these as well.
3. Briefly describe the organization's financial and operational capacity to support the proposed project activities. Address financial administration/management experience and procedures, governance, and human resource capacity.

Assessment Criteria:

• Degree to which the organization has the necessary skills, experience, and relationships to successfully carry out the proposed capacity building activities. The contributions of confirmed partners may be considered here as well.
• Degree to which key roles and responsibilities are clearly described, and are appropriate to the skills and capacity of the responsible party.
• Degree to which the organization has the necessary financial capacity to successfully carry out the proposed capacity building activities.

Section 8: Target Populations and Beneficiaries

1. Briefly describe the organization's relationship with individuals that have criminal records and require support services, including with relevant organizations, community groups, researchers, service providers, and others as appropriate.
2. Describe the target population(s) to be reached through the proposed project activities. Address how the proposed activities will consider the needs and circumstances of distinct groups of people within the target population(s).
3. Describe who will ultimately benefit from the proposed activities, if different from target populations.

Assessment Criteria:

• Degree to which the proposed project is informed and supported by strong relationships with target population.
• Degree to which the organization has diverse community engagement with a visible constituency.
• Degree to which proposed target population(s) are described and appropriate.
• Degree to which subgroups within the proposed target population(s) have been identified and considered in project design.
• Degree to which proposed beneficiaries are described and appropriate (if applicable).

Section 9: Overview of Proposed Work

Note: In addition to the narrative description here, you are also asked to complete the workplan template in Section 10.

1. Describe the goal(s) of the proposed project. Explain how these goals align with the objectives and principles of the Program.
2. Describe the key activities, timelines, and outputs of the proposed project. Essentially, explain how the project will be carried out.
3. Describe how will the project activities and outcomes support public policy issues of strategic importance, like reintegration.
4. Describe how the expected outcomes listed in the project work plan will enable the design, development, implementation, and evaluation of the project.

Assessment Criteria:

• Degree to which goals are clear, realistic, achievable, and align with the objectives, principles, and eligibility criteria for the Program.
• Degree to which proposed activities and outputs are clearly described, realistic, appropriate, and achievable within proposed timelines.
• Degree to which short-term and medium-term results are clearly described and appropriate for proposed objectives and activities.
• Degree to which the geographic location(s)/setting(s) where the proposed activities will take place are clearly identified and appropriate (i.e., reasons why they were selected).

Section 10: Workplan

Complete the detailed Workplan Template below to define the activities the project will undertake to achieve its anticipated outcomes. Replicate as needed.

Consider:
Activity: What actions are to be taken to meet the objectives?
Description and Milestones: Briefly describe how the activities will be conducted. Ensure activity related expenditures are reflected in the budget.
Timelines: When and/or how long will the activities occur? (be specific with start and end dates)
Expected Outcomes: (immediate, intermediate and long-term)

Activity #1:
Description and Milestones:
Timelines:
Expected Outcomes:

Activity #2:
Description and Milestones:
Timelines:
Expected Outcomes:

Activity #3:
Description and Milestones:
Timelines:
Expected Outcomes:

Activity #4:
Description and Milestones:
Timelines:
Expected Outcomes:

Assessment Criteria:

• Degree to which the workplan and timetable identifies well-defined activities that will achieve project objectives.
• Degree to which proposed timelines are feasible and appropriate to proposed activities.
• Degree to which the proposed outputs and results are feasible and appropriate to proposed activities.

Section 11: Budget

Complete the detailed Budget Template below to provide details of all activities and associated costs for the project duration.

If applicable, provide a summary of leveraged in-kind and financial contributions from partners or other sources.

Note:

• All costs must be directly related to the project.
• Any claims for travel are closely scrutinized and must show a solid rationale. For example, give details as to why it is essential for face-to-face meetings versus teleconferences, how it is project-specific and not part of on-going operations, and that participants are project-related, not only internal staff for regular management.
• Space or equipment owned by the organization should be identified as an in-kind (non-financial) contribution.
• Budget forecasting should be based on the federal government's fiscal year (April 1 to March 31).

For further information, consult the following websites:

• Canada Revenue Agency (re: Employer's share of payroll deductions and benefits) http://www.cra-arc.gc.ca/menu-e.html
• Treasury Board Guidelines for travel and hospitality costs
  • https://www.tbs-sct.gc.ca/pol/doc-eng.aspx?id=27228 (hospitality)
  • National Joint Council Travel Directive, available at http://www.njc-cnm.gc.ca/directive/d10/v238/en (travel)

Assessment Criteria:

• Total funding requested from PS is appropriate for the proposed activities.
• The funding allocated to the proposed activities demonstrates value for money.
• Degree to which the budget explanations provided are clear and appropriate for proposed activities.

Revenues

1. Cash: actual dollar value or revenues/funding received
2. In-Kind: non-cash input which is given a cash value

Fiscal Year 2022-23

Government Funding^{Footnote *} (Cash)

• Public Safety Canada:
• Municipal:
• Provincial:
• Territorial:

Subtotal (Cash):
Government Funding (In-Kind) (list any applicable)

Subtotal (In-Kind):
Total Government Funding:
Non-Government Funding
Subtotal – Cash:
Subtotal - In-Kind:
Total Non-Government Funding and Other

Total Revenues

Fiscal Year 2023-24

Government Funding^{Footnote *} (Cash)

• Public Safety Canada:
• Municipal:
• Provincial:
• Territorial:

Subtotal (Cash):
Government Funding (In-Kind) (list any applicable)

Subtotal (In-Kind):
Total Government Funding:
Non-Government Funding
Subtotal – Cash:
Subtotal - In-Kind:
Total Non-Government Funding and Other

Total Revenues

Fiscal Year 2024-25

Government Funding^{Footnote *} (Cash)

• Public Safety Canada:
• Municipal:
• Provincial:
• Territorial:

Subtotal (Cash):
Government Funding (In-Kind) (list any applicable)

Subtotal (In-Kind):
Total Government Funding:
Non-Government Funding
Subtotal – Cash:
Subtotal - In-Kind:
Total Non-Government Funding and Other

Total Revenues

Fiscal Year 2025-26

Government Funding^{Footnote *} (Cash)

• Public Safety Canada:
• Municipal:
• Provincial:
• Territorial:

Subtotal (Cash):
Government Funding (In-Kind) (list any applicable)

Subtotal (In-Kind):
Total Government Funding:
Non-Government Funding
Subtotal – Cash:
Subtotal - In-Kind:
Total Non-Government Funding and Other

Total Revenues

Expenses

Enter the amount in Canadian dollars for each eligible cost category below for each fiscal year 2022-23, 2023-24, 2024-25, and 2025-26 (up to March 31st).

Fiscal Year 2022-23

Salaries and wages for permanent or temporary professional, clerical, technical and administrative services, including contributions to the Canada Employment Insurance Commission, the Canada Pension Plan, the Workers' Compensation Board, the Provincial Pension Plan or other Employee Benefit Plans.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Professional fees for subject matter experts.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Services for personnel administration, accounting and bookkeeping, processing lawyers' accounts and audit fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Rent, normal utilities such as electricity, heat, water and telephone, maintenance of offices and other buildings, insurance and taxes, conference room and meeting room rentals, where these expenses are directly related to the project and are not core or ongoing expenses.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Office equipment and minor capital acquisitions net of disposal (less than $5,000 per acquisition). Best value on rental versus purchase of equipment should be determined and the equipment should be retained throughout the project and only be replaced as required.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Program supplies and materials (less than $5000 per acquisition).

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Travel and living expenses related to the delivery of the project, including transportation rental costs, vehicle leases and insurance for vehicles, which are deemed reasonable through the detailed budget review and not to exceed the maximum National Joint Council (NJC) guideline amount. Travelers should be reimbursed based on receipts up to the eligible reimbursement amount.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Transportation, inclusive of rental vehicle costs, non-capital vehicle leases and related insurance, bus tickets, tokens and other participant-related transportation reimbursements.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Training, learning, and development programs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Administrative expenses should be clearly defined and should not exceed 15% of the total contribution provided by the Department for a specific project, if not already included within other line items. If administrative expenses are already included in other line items, then the percentage will be reduced accordingly.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Honoraria, defined as time-limited remuneration for a volunteer service or participation in project delivery that is consistent with, and essential to the attainment of, the project's objectives. This can include but is not limited to guest speakers and Elder honoraria. Honoraria cannot be provided as an incentive for participation in a project.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Computer services, library expenses, research costs and collection and analysis of statistics.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Public awareness and educational activities consistent with the project's objectives.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Advertising and marketing costs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Translation and simultaneous interpretation activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Shipping charges, postage, licences, and other fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Printing and distribution activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Hospitality in Indigenous contexts

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Subtotal - Cash Fiscal Year 2022-23

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Fiscal Year 2023-24

Salaries and wages for permanent or temporary professional, clerical, technical and administrative services, including contributions to the Canada Employment Insurance Commission, the Canada Pension Plan, the Workers' Compensation Board, the Provincial Pension Plan or other Employee Benefit Plans.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Professional fees for subject matter experts.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Services for personnel administration, accounting and bookkeeping, processing lawyers' accounts and audit fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Rent, normal utilities such as electricity, heat, water and telephone, maintenance of offices and other buildings, insurance and taxes, conference room and meeting room rentals, where these expenses are directly related to the project and are not core or ongoing expenses.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Office equipment and minor capital acquisitions net of disposal (less than $5,000 per acquisition). Best value on rental versus purchase of equipment should be determined and the equipment should be retained throughout the project and only be replaced as required.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Program supplies and materials (less than $5000 per acquisition).

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Travel and living expenses related to the delivery of the project, including transportation rental costs, vehicle leases and insurance for vehicles, which are deemed reasonable through the detailed budget review and not to exceed the maximum National Joint Council (NJC) guideline amount. Travelers should be reimbursed based on receipts up to the eligible reimbursement amount.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Transportation, inclusive of rental vehicle costs, non-capital vehicle leases and related insurance, bus tickets, tokens and other participant-related transportation reimbursements.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Training, learning, and development programs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Administrative expenses should be clearly defined and should not exceed 15% of the total contribution provided by the Department for a specific project, if not already included within other line items. If administrative expenses are already included in other line items, then the percentage will be reduced accordingly.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Honoraria, defined as time-limited remuneration for a volunteer service or participation in project delivery that is consistent with, and essential to the attainment of, the project's objectives. This can include but is not limited to guest speakers and Elder honoraria. Honoraria cannot be provided as an incentive for participation in a project.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Computer services, library expenses, research costs and collection and analysis of statistics.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Public awareness and educational activities consistent with the project's objectives.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Advertising and marketing costs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Translation and simultaneous interpretation activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Shipping charges, postage, licences, and other fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Printing and distribution activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Hospitality in Indigenous contexts

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Subtotal - Cash Fiscal Year 2023-24

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Fiscal Year 2024-25

Salaries and wages for permanent or temporary professional, clerical, technical and administrative services, including contributions to the Canada Employment Insurance Commission, the Canada Pension Plan, the Workers' Compensation Board, the Provincial Pension Plan or other Employee Benefit Plans.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Professional fees for subject matter experts.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Services for personnel administration, accounting and bookkeeping, processing lawyers' accounts and audit fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Rent, normal utilities such as electricity, heat, water and telephone, maintenance of offices and other buildings, insurance and taxes, conference room and meeting room rentals, where these expenses are directly related to the project and are not core or ongoing expenses.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Office equipment and minor capital acquisitions net of disposal (less than $5,000 per acquisition). Best value on rental versus purchase of equipment should be determined and the equipment should be retained throughout the project and only be replaced as required.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Program supplies and materials (less than $5000 per acquisition).

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Travel and living expenses related to the delivery of the project, including transportation rental costs, vehicle leases and insurance for vehicles, which are deemed reasonable through the detailed budget review and not to exceed the maximum National Joint Council (NJC) guideline amount. Travelers should be reimbursed based on receipts up to the eligible reimbursement amount.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Transportation, inclusive of rental vehicle costs, non-capital vehicle leases and related insurance, bus tickets, tokens and other participant-related transportation reimbursements.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Training, learning, and development programs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Administrative expenses should be clearly defined and should not exceed 15% of the total contribution provided by the Department for a specific project, if not already included within other line items. If administrative expenses are already included in other line items, then the percentage will be reduced accordingly.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Honoraria, defined as time-limited remuneration for a volunteer service or participation in project delivery that is consistent with, and essential to the attainment of, the project's objectives. This can include but is not limited to guest speakers and Elder honoraria. Honoraria cannot be provided as an incentive for participation in a project.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Computer services, library expenses, research costs and collection and analysis of statistics.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Public awareness and educational activities consistent with the project's objectives.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Advertising and marketing costs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Translation and simultaneous interpretation activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Shipping charges, postage, licences, and other fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Printing and distribution activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Hospitality in Indigenous contexts

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Subtotal - Cash Fiscal Year 2024-25

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Fiscal Year 2025-26

Salaries and wages for permanent or temporary professional, clerical, technical and administrative services, including contributions to the Canada Employment Insurance Commission, the Canada Pension Plan, the Workers' Compensation Board, the Provincial Pension Plan or other Employee Benefit Plans.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Professional fees for subject matter experts.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Services for personnel administration, accounting and bookkeeping, processing lawyers' accounts and audit fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Rent, normal utilities such as electricity, heat, water and telephone, maintenance of offices and other buildings, insurance and taxes, conference room and meeting room rentals, where these expenses are directly related to the project and are not core or ongoing expenses.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Office equipment and minor capital acquisitions net of disposal (less than $5,000 per acquisition). Best value on rental versus purchase of equipment should be determined and the equipment should be retained throughout the project and only be replaced as required.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Program supplies and materials (less than $5000 per acquisition).

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Travel and living expenses related to the delivery of the project, including transportation rental costs, vehicle leases and insurance for vehicles, which are deemed reasonable through the detailed budget review and not to exceed the maximum National Joint Council (NJC) guideline amount. Travelers should be reimbursed based on receipts up to the eligible reimbursement amount.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Transportation, inclusive of rental vehicle costs, non-capital vehicle leases and related insurance, bus tickets, tokens and other participant-related transportation reimbursements.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Training, learning, and development programs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Administrative expenses should be clearly defined and should not exceed 15% of the total contribution provided by the Department for a specific project, if not already included within other line items. If administrative expenses are already included in other line items, then the percentage will be reduced accordingly.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Honoraria, defined as time-limited remuneration for a volunteer service or participation in project delivery that is consistent with, and essential to the attainment of, the project's objectives. This can include but is not limited to guest speakers and Elder honoraria. Honoraria cannot be provided as an incentive for participation in a project.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Computer services, library expenses, research costs and collection and analysis of statistics.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Public awareness and educational activities consistent with the project's objectives.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Advertising and marketing costs.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Translation and simultaneous interpretation activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Shipping charges, postage, licences, and other fees.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Printing and distribution activities.

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Hospitality in Indigenous contexts

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Subtotal - Cash Fiscal Year 2025-26

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Total Expenditures for Project Cycle 2022-23, 2023-24, 2024-25, and 2025-26

• Public Safety Canada Funding: $
• Other Government Funding: $
• Non-Government Funding: $
• Total: $

Section 12: Conditions

In the event that your funding application is successful, you will be required to provide information to process electronic payments (if not already provided).

Departmental funding may be used only for the purposes specified in this application. Once the Department has agreed to provide financial support to your project, no major change can be made without departmental approval (in each case, the Department shall determine what constitutes a major change). Funds not used for these purposes must be returned to the Department.

The organization bears full responsibility for its debts. The Department will not consider any request for assistance in settling debts. The organization must agree to comply with all provincial, territorial and federal legislation. The Department's financial contribution must be explicitly acknowledged and must be mentioned in publications funded by the Department. A typical form of acknowledgement is, "We acknowledge the financial support of the Government of Canada/Public Safety Canada".

With respect to the project or programming for which funding is requested, the organization shall agree to comply with the spirit and intent of the Official Languages Act by implementing the appropriate linguistic measures indicated on the call for proposals.

The organization is in accordance with the terms and conditions regarding intellectual property rights described in the call for proposals.

By signing this application, the organization authorizes Public Safety Canada to disclose any information received in this application within the Department and the Government of Canada or to outside entities for the following purposes: to reach a decision on this application, to administer and monitor the implementation of the project or programming, or to evaluate the results of the project or programming after the project completion. The disclosure of any information received in this application may also be used to reach a decision on any other application of the organization for funding under any other departmental program.

In the event of access to information requests regarding the present funding application or any relevant information about the organization in the Department's possession, the information provided to the Department will be entirely disclosed, with the exception of personal information, which will be treated in accordance with the Privacy Act.

Section 13: Application Checklist

A complete application must consist of the following mandatory documents:

• Project Application Form
• Most recent Annual Report
• Most recent Financial Statement

Section 14: Approval

Please ensure Section 14: Approval remains in its entirety on the same page when submitting the application.

The undersigned on behalf of the organization declares that:

• The information in this application is accurate and complete;
• The application is made on behalf of the organization named, whose name appears in Section 1, with its full knowledge and consent;
• If financial assistance is granted, the organization shall undertake to provide financial statements and reports on results pursuant to the requirements of Public Safety Canada;
• If financial assistance is provided, the organization shall agree to an assessment of the funded project or programming pursuant to the requirements of Public Safety Canada;
• No public servant or holder of public office, past or present, which is in breach of the Values and Ethics Code for the Public Sector or the Conflict of Interest Act shall derive a direct benefit from the requested funding;
• This organization has not paid or agreed to pay, directly or indirectly, and agrees that it shall not pay, directly or indirectly, any contingency fees for the solicitation, negotiation or acquisition of funding for the purposes of this application.

I acknowledge that should this funding request be approved, funding will be conditional upon the organization signing a written agreement with Public Safety Canada.

1. Name:
   Title:
   Telephone Number:
   Fax Number:
   E-Mail Address:
   Signature of Authorized Representative:
   Date:
2. Name:
   Title:
   Telephone Number:
   Fax Number:
   E-Mail Address:
   Signature of Authorized Representative:
   Date:

Note: Must be signed by individual(s) authorized to legally bind the organization