Grant Application Form - Victoria Brain Injury Society

Grant Application Form

Grant Applications must be received by the Town on or before March 1st of each year

Basic Information

For what type of grant are you applying?

Category: [X] Program (annual operations)

Project / Event / Program Name & Description: Peer Support Expansion – Mental Health, So The Peer Support Program creates a safe, welcoming space where adults living with ac This program is not only therapeutic; it’s transformative. Participants develop social netv With this grant, VBIS will expand peer support to reach more View Royal residents by ol

Grant amount applied for? $ 4,500 % of project/event/program budget 15 % Date the project, activity, event or program will occur: March 1, 2026 - March 31, 202

Has your organization ever received grant funding from the Town? [X] Yes * 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? [X] No * If yes, in what year(s)? _______________________________________________

Does your organization issue grants to other organizations? [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: Victoria Brain Injury Society

Contact: Pam Prewett Title: Grants Manager Society Registration Number: S-0018491 Year Registered: 1983 Charity Registration Number: 122452121-001 Year Registered: 2005 Year Founded: 1983 Fiscal year end: 31 / Mar

List any other geographic areas in which your organization operates: Victoria, View Royal, Esquimalt, Highlands, Sooke, Metchosin, Port Renfrew, Saanich, Sidney, Langford, Oak Bay, Central Saanich

Your Organization’s Personnel

1) Organization Executive and Staff: President: Shannon Kowalko Secretary/Treasurer: Steve Wellburn

Board Members:

• Steven Gordon
• Fatimah Banki
• Linsay Byers
• Tracey Thompson
• Leigh Anne Swayne
• Brad Norris-Jones
• Ed Adams
• Natalie Foley

2) List the staff or volunteer positions involved in carrying out the project:

Your Organization’s Objectives and Services

1) Describe your organization’s mission statement and how your services meet them: (No text entered)

Your Proposed Program Budget

1) Please list all expenses and sources of project revenue, including “in-kind” contributions from your (or any other) organization.

Details of Your Organization’s Grant Request

1) Nature and goals of the project, program or event: (No text entered)

2) Summary of direct and indirect benefits to the Town of View Royal: (No text entered)

Conditions of Funding

1. The applicant must acknowledge the support of the Town in all printed and publicity material related to the project, event, or program;
2. 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.
3. 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.
4. 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.
5. 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.
6. 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: Shannon Kowalko Title: Board Chair Date: February 9, 2026

Name: Steve Wellburn Title: Board Treasurer Date: February 9, 2026

Submission Information

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