Grant Application Form - The Bike Victoria Society
Funding application for the 'Everyone Rides Grades 4&5' (ERG45) program at Eagle View Elementary school.
Grant Application Form
Grant Applications must be received by the Town on or before March 1st, 2021
Basic Information
For what type of grant are you applying?
Category: [ ] Specific Project [ ] Special Event [X] Program (annual operations)
Project / Event / Program Name & Description: Everyone Rides Grades 4&5 at Eagle View Elementary
Grant amount applied for? $ 1,300 % of project/event/program budget 50 % Date the project, activity, event or program will occur: May-June 2021
Has your organization ever received grant funding from the Town? [X] Yes [ ] No
- If yes, attach copies of printed material which acknowledged the financial support of the Town.
Has your organization received a permissive tax exemption from the Town? [ ] Yes [X] No
- If yes, in what year(s)?_______________________________________________
Does your organization issue grants to other organizations? [ ] Yes [X] No
- If yes, you must demonstrate that any funding provided by the Town will not be used to fund grants to other organizations and attach it to this grant application form.
Attachments Required
- Resolution of Board of Directors to request a Grant in Aid from the Town of View Royal. ** If there is no Board of Directors, a statement of request must be signed by the majority of the members of the non-profit or community organization.
- Prior years financial statements of the organization.
- Documentation Town funding will not be used to fund grants to other organizations (if applicable)
About Your Organization
Legal Name of Organization: The Bike Victoria Society (Formerly Bike to Work Society) Mailing Address: PO Box 8837 Victoria, BC V8W 3S3 Operating at: 1034 Hillside Ave. Victoria, BC V8T 2A5 Email: Admin@biketowork.ca Contact: Adam Krupper Title: Executive Director Society Registration Number: S-37679 Year Registered: 2019 (Formerly 1997) Charity Registration Number: n/a Year Registered: n/a Year Founded: 1995 Fiscal year end: 30 / 09 (day) (month) List any other geographic areas in which your organization operates: We operate in all 13 municipalities in Greater Victoria
Your Organization’s Personnel
1) Organization Executive and Staff: President: Corey Burger Telephone: Secretary/Treasurer: Steve McKay Telephone:
Board Members: Edward Pullman, Kate Bergen Meredith James, Niki Sutherland Rebecca Freedman, Stephen McMurray Hu Wallis, Ryan Del Monaco Tim Schober and Joan Stonehocker, Emma Dayton and Kemal Tunador
2) List the staff or volunteer positions involved in carrying out the project:
| Name and Position | Paid | Volunteer |
|---|---|---|
| Adam Krupper, Executive Director | [X] | |
| Justine Bochenek, Program Coordinator | [X] | |
| Lana Taves, Bike Skills Manager | [X] | |
| 5x Bike Skills Instructors | [X] | |
| School Staff | [X] |
Your Organization’s Objectives and Services
1) Describe your organization’s mission statement and how your services meet them: The Bike Victoria Society is a registered non-profit society governed by a volunteer Board of Directors. The Society has over 800 volunteers and a growing membership currently at 264. Our mandate is to help more people bike more places more often. To execute this mandate, we run two main program streams: Go By Bike Week (spring, fall, winter) and Bike Skills safety courses for kids, youth, and adults throughout the region.
Your Proposed Program Budget
1) Please list all expenses and sources of project revenue, including “in-kind” contributions from your (or any other) organization.
| A. Income | Last Fiscal Year (If program was in existence) | This Fiscal Year (Proposed program budget) |
|---|---|---|
| Town of View Royal | ||
| Fees or Membership Dues | Please see attached supporting document for approved budget. | |
| Government Revenue (specify below) | ||
| Interest income | ||
| Bingo revenues | ||
| Direct access revenues | ||
| Fundraising projects | ||
| Other Revenue (specify below) | ||
| TOTAL INCOME |
| B. Expenses | ||
|---|---|---|
| Administration | ||
| Wages/Honouraria/Benefits | ||
| Supplies and Equipment | ||
| Major Capital Costs | ||
| Mortgage/Rent/Utilities | ||
| Fees (licensing, etc.) | ||
| Insurance | ||
| Advertising/Printing/etc. | ||
| Other (specify below) | ||
| TOTAL EXPENSES |
Details of Your Organization’s Grant Request
1) Nature and goals of the project, program or event: Please see supporting documentation.
2) Summary of direct and indirect benefits to the Town of View Royal: Please see supporting documentation.
Conditions of Funding
- The applicant must acknowledge the support of the Town in all printed and publicity material related to the project, event, or program;
- Funds must be used for the purpose for which they were requested. Any funds not used for the requested purpose must be returned to the Town.
- Funds will be released as follows: a. Grants in aid provided for annual programs will be released at 100% at time of approval by Council; b. Grants in aid provided for special projects or events will be released at 50% at time of approval by Council and 50% after receipt of the final report; c. Conditional grants in aid will be paid 100% upon satisfactory proof that the conditions, as set by Council, have been met.
- Organizations receiving grants from the Town shall provide an accounting of the project or program for which the grant was approved as follows: a. Where the grant in aid was for a specific project or event the applicant must submit a final report within 45 days after the project or event is complete. b. Where the grant in aid was in support of an annual program, the applicant must submit a final report within 60 days of the end of the organization’s fiscal year.
- An final report must include the following information: i. Evaluation of the project, event, or program; ii. Financial statement of actual revenue and expenses for the project, event or program; iii. Attendance figures, if applicable; iv. Number of participants in the project, event, or program; and v. Evaluation of the direct and indirect benefits to the Town.
- In the event that the project or program is not completed, the grant recipient organization must notify the Town as soon as practical and refund any grant funds that have been provided for that project.
Your Directors’ Declaration
We, the undersigned, do hereby certify that this application and all appended forms and/or documents contain a full and accurate account of all matters stated:
Name: Adam Krupper Name: Corey Burger
Date:__________________________ Date:__________________________
Please submit your completed application to: Town of View Royal 45 View Royal Ave Victoria, BC V9B 1A6 www.viewroyal.ca Fax 250-727-9551 email: finance@viewroyal.ca
