Community Report
Haines Junction Lotteries Grant Form
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Indicates required field
Name
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First
Last
Email
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Phone Number
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PO Box
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Name of Organization
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Please list the names of board members/key volunteers associated with this project
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Please identify the category that best describes your event/program/project?
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Innovate: a new idea or activity for HJ that will provide residents with a new opportunity
Sustain: a pre-existing idea or activity for HJ that has provided and will continue to provide valuable opportunities for residents
What grant amount are you requesting? (Lowest amount $100, Highest amount $7000)
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This an application for a:
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Event (Tournament, Festival, Performance, etc)
Program (things like sport, art or cultural associations that operate year after year)
Special Project (everything else!)
What is the name your event/program/project?
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Have you received funding from the Haines Junction Lotteries Grant before? And When?
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What is the timeframe of your event/program/project?
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Please state the venue(s) where this event/program/project will take place
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Please state the venue(s) where this event/program/project will take place (choose any)
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St. Elias Community School (inside)
St. Elias Community School (yard)
The Youth Centre
The Bill Brewster Arena
The Pool
Da Ku
The St. Elias Convention Centre
Yukon College
The Library
Mun Ku
Other Venue:
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Please provide a detailed description of your project/event:
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Please rank the following potential outcomes of the project you are proposing. #1 is the main potential outcome.
#1
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promotes health, wellness and active living
enhancement of community identity/pride
potential to create or strengthen community partnerships
positive impact on economic/tourism development
not applicable
Please provide a statement on how you believe this project will achieve the outcome you have listed above:
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#2
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promotes health, wellness and active living
enhancement of community identity/pride
potential to create or strengthen community partnerships
positive impact on economic/tourism development
Please provide a statement on how you believe this project will achieve the outcome you have listed above:
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#3
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promotes health, wellness and active living
enhancement of community identity/pride
potential to create or strengthen community partnerships
positive impact on economic/tourism development
Please provide a statement on how you believe this project will achieve the outcome you have listed above:
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#4
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promotes health, wellness and active living
enhancement of community identity/pride
potential to create or strengthen community partnerships
positive impact on economic/tourism development
Please provide a statement on how you believe this project will achieve the outcome you have listed above:
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Please provide a statement providing evidence that there is a need in Haines Junction for this initiative.
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Your numbers...
# of volunteers
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# of participants
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# of paid organizers (instructors / employees / contractors)
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Please identify how you intend to measure the success of your project. Please include any specific measurements you will be tracking (registration numbers, ticket sales, attendees, etc)
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Are you applying or have you received other funding for this project in this fiscal year (April 1 - March 31)
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Budget
Please complete the budget form.
Submit
Community Report
