New Ministries
Grant Application Form

Please choose one:

Spring Cycle_________(year)         Fall Cycle_________(year)

For assistance please visit the website: http://www.edge-ucc.ca/ 
or contact New Ministry Animators: 

Christine Jerrett (Rural & Small Town Ministries)
cjerrett@edge-ucc.ca 
Lauren Hodgson (Urban & Suburban Ministries)
 lhodgson@united-church.ca 
Phone: 800-268-3781 x4076 (voicemail only) 

Part One: Organization Details

Applicant Information
Project Name: ________________________________________________________________

Name of Faith Community or Organization managing the application: 
____________________________________________________________________________

Mailing Address: _____________________________________________________________

City / Prov. / Postal Code: _______________________________________________________

Daytime Phone: _____________________________________________

E-mail: _____________________________________________________

Fax: ________________________________________________________

Website: _____________________________________________________

Charitable Registration Number: ________________________________________________
*Note: It is not necessary for New Ministry grant applicants to be supported by a congregation; however, to process applications, we will need an organization with a charitable registration number associated with this application. 

Have you received granting monies from The United Church/United Church Foundation before?
Yes	No	

Amount: $_______________________________
Year: ___________________________________
Source: _________________________________

Contact Information
Contact Name: _______________________________________________________________

Title: _______________________________________________________________________
Phone (work): _______________________________________
Phone (cell): _________________________________________
Phone (home): _______________________________________

E-mail: __________________________________________________

Application Approval 
Will the above applicant organization be receiving the granting funds directly? 	Yes
No 
*If no, please fill out the information below 	
Name of Organization to Receive Funds: 		
Primary Contact Name: 		
Title: 		
Mailing Address: 		
City / Province / Postal Code:		
Daytime Phone: 		
Email: 		
Fax: 		
Website: 		
Charitable Registration Number: 		
Signature of Primary Contact		

This application has been approved by: (check all that apply) 
Please note: if your project requires Presbytery approval, please include related documentation with your application.
Council/Board of Congregation or Pastoral Charge
Camp
School
Outreach Ministry
Other: 

Name of Church or Ministry: ___________________________________________________

Print Name of Signing Officer: __________________________________________________
*A signing officer includes the chair, secretary or other authorized person of the pastoral charge or supporting organization. If presbytery or conference is listed as the supporting body for this application, they must be notified and this application must have been discussed in advance of applying.  
Title of Signing Officer: ________________________________________________________

Signature of Signing Officer: ____________________________________________________

Date: _________________________________

Part Two: Project Overview

Funding Year: ________________________

Funding Cycle: 
Spring 	Fall 	

Is this a new project or does it grow out of a previous ministry project? If it grows out of a previous ministry project, please describe that project and its relationship to this project.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Targeted Project Implementation Date: __________________________________

Targeted Completion Date: ____________________________________________

Project Team Members: 
Name	Designated Role(s)	

		

Project Team Members Contd. (if more space needed): 

Project Description (100 words maximum)

	
Project Uniqueness (Preference is given to innovative projects) (250 words maximum)

	
Project Goals and Objectives (250 words maximum)

	
Plan for Achieving Stated Goals and Objectives (250 words maximum)

	
Plan for Project Implementation and Delivery (250 words maximum)

	
Project Beneficiaries (100 words maximum)

	
Examples of Demonstrated Support (e.g. partners, letters of support, details of community involvement, etc.) (250 words maximum)

	
Describe how the Support Received from The United Church of Canada/The United Church of Canada Foundation will be Acknowledged/Recognized if your application is successful, and where this will be communicated (website, letter head, email signatures etc.) (100 words maximum) 

	

Part Three: Project Revenues and Expenses 

Project Revenues
Project Revenues	Amount	Confirmed
(Yes / No)	Anticipated Grant Confirmation Date	
Organization Funds
What amount of financial assistance will the sponsoring organization be providing to this new ministry (through monetary support and in-kind)? 	$	Y       N		
Other United Church of Canada Support 	$	Y       N		
Other Grants	$	Y       N		
Other Fundraising 	$	Y       N		
Funding from Partners 	$	Y       N		
Amount Requested from New Ministries Fund	$			
Total Revenues 	$			

Is this a multi-year grants request?
Yes 	No 	

If so how many years and how much per year? ___________________________________
(e.g. $10,000.00, per year over 3 years)

Project Expenses
Expense	Amount	
Project Staff 	$	
Project Materials and Supplies	$	
Project Publicity	$	
Other	$	
Total Expenses 	$ 	

Major Project Expenses

		

		

		

		

What aspects of the project will the Foundation’s New Ministry Grant support? What will the grant money fund and make possible? (250 words maximum) 

	

Part Four: Project Evaluation

Anticipated Measurable Outcomes (250 words maximum)

	
Plan to Assess Measurable Outcomes (250 words maximum)

	

Timeframe for Achieving Anticipated Outcomes
Timeline	Anticipated Outcome	

		

		

		

Part Five: Declaration of Intent

On behalf of the applicant(s), I declare that if awarded a grant by The United Church of Canada / The United Church of Canada Foundation Joint Grants Committee, the organization named on the Grant Application Form shall use the funds awarded solely and explicitly for the purposes stated and in accordance with the Statement of Expenditure (budget) as submitted and approved. 
Any portion of the grant funds not used for the purposes stated in the Grant Application Form or any portion not required to complete the project or meet the objectives as described, will be returned to The United Church of Canada Foundation, unless prior written permission to vary the stated purposes is obtained from the Joint Grants Committee.  
It is agreed that if the applicant is awarded funding, the organization will provide to the Foundation staff, within ninety (90) days of project completion, the following documentation:
•	a detailed report submitted to the Foundation one year after receiving the grant on the funded project as outlined on the Seeds of Hope Grant Follow-Up Report Guideline document.
•	one copy of all promotional pieces associated with the project including press releases, printed material and internet advertising
•	any other relevant information that may serve to assist in satisfying the United Church/Foundation requirements
Recipients of New Ministry Grants will be accompanied by an Animator for New Ministry Development. The recipient will provide a progress report part-way through the funding cycle. 
The conditions stated above have been reviewed and agreed upon by signing authorities for the organization named on the Grant Application Form.

Print Name of Signing Officer: ____________________________________________

Title of Signing Officer: __________________________________________________

Signature of Signing Officer: ______________________________________________

Signed at: ________________________ 	Date: ___________________________