Fillable Form 1.: Community Partnership Program Application (Vancity)

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Form 1.: Community Partnership Program Application (Vancity)

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The Form 1.: Community Partnership Program Application (Vancity) form is 6 pages long and contains:

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  • 16 check-boxes
  • 171 other fields

Country of origin: CANADA
File type: PDF

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Form_1586 (2018-09-07)
Page 1 of 6
Instructions:
Date (yyyy-mm-dd):
1.
Save the form to your computer
2.
Complete all sections of the form. Applications will only be considered when completed in full
3.
Email the full application to communitypartnerships@vancity.com
Section 1 – Impact Region(s)
Main Impact Region - Choose Area
Other Region(s) list all, if applicable
Community Partnership Program
Application
Clear Fields
Section
2
-
Organization
Information
Legal Business / Organization Name
Street Address
City / Town
Province
Postal Code
Website
Organization Type
Social
Enterprise
Not-for-profit
Indigenous
Labour
Union
Co-op # / Provincial Society # / BN # / Charitable # - please ensure to include all that apply
Umbrella Organization if applicable
Organization’s Mission / Details of Organization - maximum 200 words
Number of Staff
Number of Volunteers
Annual Budget
Year Founded
Select Region
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Section 3 – Contact Information
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Section 4 – Project Information
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Organization
Role
Contact Person
Form_1586 (2018-09-07)
Page 3 of 6
Section 5.0 – Program Guidelines: Financial Empowerment & Climate Justice
Section 5 – Initiative Funding
Funding Requested maximum $10,000
Total Project Budget
Funds Secured to Date
Describe what your organization is doing to build its long-term financial stability
Have you applied for funding through a Vancity program previously?
Yes
No
Is your organization currently working with/being supported by Vancity?
Yes
No
Section 5.1 - Community Partnership Program Themes
We seek to support organizations that will implement solutions that help under-served communities & local
businesses build financial resilience to safeguard against the climate crisis, life’s emergencies, reduce the risk
of financial hardship, and withstand financial shocks. Please also inform us if:
Your initiative is led by or will partner with Indigenous, Black, People of Color, Newcomers, Women, Persons with
Disabilities or other under-served communities in the planning and delivery of the project
Your initiative involves two or more organizations who are collaborating to deliver your work or build your capacity
to expand or maintain services and support your clients
Please review the criteria below carefully and select all that apply. Your initiative will:
*For more support related to environmental sustainability, please check out our Vancity enviroFUND program
Design & deliver economic activities that address the climate transition with a racial equity justice lens, &
will enable communities and small businesses to build financial resilience, withstand financial shocks and take
action on climate change. Examples include:
• Re-training and up skilling workforces on green initiatives
• Building workshops, virtual platforms, networking or mentorship programs
• Creating climate solutions and awareness initiatives for businesses
• Developing strategies to safeguard against financial shocks
Increase access to safe & stable employment opportunities that will help under-served individuals
and communities. Examples include:
• Providing employment education & training
• Creating good green stable jobs
• Building entrepreneurship skills
• Building assets and human capital (eg. education) to move out of poverty
• Providing safe and affordable banking access
• Ensuring fraud and financial abuse protection
Improve financial inclusion by increasing access to resources that will financially empower under-served
communities - such as financial information, education, and coaching to build financial capability and assets.
Examples include:
Form_1586 (2018-09-07)
Page 4 of 6
If Yes, provide details of how you were / are supported by Vancity (what support, from which area & who):
Section 7 – Impact Information & Project Work Plan
How will you evaluate the success of your project? What desired outcomes will you measure? e.g. What: 100 employees
reduce their ecological foot print. How: 1:1 qualitative interviews with participants
What
How
How does your initiative align with what the Community Partnership Program is trying to do for building financial empowerment and
achieving climate justice? How does your project support the criteria you selected in section 5.0 & 5.1 above?
List the key activities of your project work plan and the anticipated completion dates (start to finish)
Date (yyyy-mm-dd)
Activity
Form_1586 (2018-09-07)
Page 5 of 6
Section 8 – Additional Details
Feel free to attach any additional proposals or documents.
It will only be referenced as additional detail and will not be considered as part of your application.
Additional Comments
We receive a large volume of requests over the course of the year and we only have a finite amount of funding to
invest into the local community for impact development. Please understand that applications that are strongly
aligned to our criteria will be given consideration. We may request more information (e.g.: organization’s business
plan, financial statements, list of Board of Directors, society certificates, timelines, etc.). For any additional
inquiries, please email communitypartnerships@vancity.com
Form_1586 (2018-09-07)
Page 6 of 6
Section 9 – Project Budget
Vancity will contribute a maximum of 70% (up to $10,000) towards the total project budget.
Total Revenues amount must match Total Expenses amount
Operational expenses that are necessary for the delivery of your initiative will be considered
Revenues
Funders
(including Vancity)
Amount
Confirmed
Contact Number
Vancity Credit Union
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Sub Total:
In-kind contributions:
Yes
No
Yes
No
Yes
No
Total Revenues
Total Revenues
Confirmed
Expenses
Expense Item
Vancity Amount
Other Funders
Amount
Total Amount
Total
Expenses
–
Vancity
Amount
Total
Expenses
–
Other
Funders
Total
Expenses
■
■
■
■
■
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Form 1.: Community Partnership Program Application (Vancity)

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Completed 1 May 2021

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