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2020/2021 CIVIL FORFEITURE CRIME PREVENTION
AND REMEDIATION GRANT PROGRAM
APPLICATION FORM
STREAM: INDIGENOUS HEALING
*Please review the Application Guide before completing this form. The Application Guide can be found here:
http://www2.gov.bc.ca/gov/content/safety/crime-prevention/community-crime-prevention/grants
SECTION 1 APPLICANT INFORMATION
Project Title:
Legal Name of Organization:
Business Name of Organization:
Location of Project (specify city/cities):
Organization’s GST/Business Number:
Applicant’s Mailing Address (Street and
Number):
Suite Number:
City/Town:
Province:
Postal Code:
Physical Location (if different from
mailing address):
Contact Person 1:
Telephone:
Email:
Contact Person 2:
Telephone:
Email:
Type of Organization (Please select one)
Local Government
Police
Academic Institution
Non-Profit Organization
School/School District
Other
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Is your organization Indigenous? (E.g. First Nations Band, Tribal Council, Friendship Centre,
Incorporated Non-Profit, Indigenous Community-Based Non-Profit, etc.)
YES NO
Has the project previously received a Civil Forfeiture Grant? If yes, please list which years the project
was funded.
YES Years?
NO
Focus on Indigenous Healing
This stream provides up to $30,000 in one-time funding to support proposals that address healing of
Indigenous peoples from the impacts of intergenerational trauma, crime or victimization in communities
across British Columbia.
NOTE: Projects should focus on healing approaches reflective of and / or aligned with Indigenous culture
and worldviews, including:
Healing for the individual, the family and/or the broader community;
Emotional, mental, physical, and spiritual aspects of healing; and
Other culturally identified practice(s) that contribute to healing.
Preferred Criteria
Preference may be given to proposals from Indigenous organizations. Non-Indigenous
organizations that apply under this stream must demonstrate how they consulted or worked
with Indigenous partners in project design and also how they will partner with Indigenous
partners in implementing the project.
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PROJECT EXECUTIVE SUMMARY:
Provide an executive summary of the project which should include the project’s name, objective,
target group (including approximate number of participants and specific segments of the population
targeted e.g. at-risk youth, homeless, LGBTQ2S+, youth ages 13-19, etc.), and types of activities to
be implemented. Provide a maximum of 5 sentences.
Example: The Two Peas in a Pod mentorship program targets at-risk youth who may be vulnerable to
become involved in gang activities. This program matches at-risk youth with a peer mentor to spend 2-3
hours per week to engage in pro-social activities such as sports, tutoring, and volunteering. It is expected
that 30 youth in this program will become more engaged with their schoolwork and family. The number
of youths charged for a criminal offence is expected to decrease.
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SECTION 2: PROJECT OVERVIEW
The project overview section of the application form should highlight the key aspects of your project
including:
Issue being addressed What is the key social issue that your project is trying to address? Why
is it important to address this issue?
Project Goals/Objectives What are the objectives/goals of the project in addressing this issue?
When the project is completed, what are you hoping to achieve? How will you measure
success/how will you know if you’ve met your objectives/goals?
Target Participants How will the project identify and engage its target participants? What is
the demographic makeup of your target participants? (e.g. gender, ethnicity, age group). How
many participants will be targeted? How many cohorts will be conducted? How long will target
participants be engaged in the project?
Level of Need Why is there a need for your project within the target audience and/or target
community? Highlight any evidence (e.g. research, data, anecdotes) demonstrating this need (if
applicable).
NOTE: For non-Indigenous organizations, please describe how you have consulted/worked alongside
Indigenous partners into your project design, implementation, and how you took into consideration
cultural safety.
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SECTION 2: PROJECT OVERVIEW CONTINUED
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SECTION 3: KEY ACTIVITIES
What key activities will the project implement to meets its goals? Include project start and end date.
Example:
Use bullet points to list the distinct individual activities with timelines that will be implemented
during the project
List as a step by step blueprint for implementing the project
o E.g. June 1 11, interview and hire mentors for youth participants
o June 10 July 10, screen potential participants based on select project criteria
Project Start Date:
Project End Date:
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SECTION 4 – ORGANIZATIONAL CAPACITY
Proposals must describe how your organization is positioned to address the issue-at-hand and
demonstrate it has the capacity to reach and support the target audience. Describe the experience your
organization and staff have that is directly related to the issue being addressed, the target audience
being reached, and the successful implementation of your proposed project.
Topics should include: Organizational structures in place to support the project; past projects similar to
the one proposed; past experience working with the target population; project planning done in
preparation (stakeholder consultation, strategic planning, needs assessments, etc.), staff
training/qualifications to deliver the project’s activities and support the specific needs of the target
audience.
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SECTION 5 – PROJECT BUDGET
Proposals must contain a reasonable and detailed budget. Consideration will be given to the scope and reach of the project in comparison to the amount of the budget (i.e., value for money). Please round all amounts to the nearest dollar.
All budget items listed must correspond to your project activities as described above. For a list of eligible and ineligible expenses, please refer to the Program Guidelines.
Example: Staff: 1 Programmer x $22.50 per hour x 15 hrs/week x 40 weeks = $13,500
Description
Amount Requested
Amount from Other Sources
Total Project Expenses
TOTAL
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SECTION 6 – DECLARATION
To be signed by an authorized signatory of the sponsoring organization, by signing you agree:
The information contained in this application is accurate and complete;
The application is made on behalf of the sponsoring organization named with its full knowledge
and consent;
The sponsoring organization is a registered legal entity in good standing;
The sponsoring organization has an appropriate accounting method to manage any potential
grant funds;
Should a project be approved, the sponsoring organization is required to submit a midterm and
final report. The reports should detail progress against the activities and outcomes described in
the application and how the grant funds are being/were spent. A link to both report templates
will be provided to you if your proposal is successful.
Name of Authorized Representative:
Title:
Signature:
Date:
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