Donation and Sponsorship Application

Donation and Sponsorship Application Form

Applications should be submitted at least one month before the event date. Requests for the donation of space for licensed events using Town facilities, as defined in the Town of Inuvik Donation and Sponsorship Policy, are not eligible for a donation. Please review the Donation and Sponsorship Policy before completing this application.
Application and Applicant Details
1. Application Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2. Applicant Type
3. Applicant Name

First NameLast Name
4. Organization Name
5. Organization/Applicant Address

Street Address

Mailing Address
CityProvince/TerritoryPostal Code
6. Applicant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
7. Applicant or Organization Email
A confirmation and copy of the completed application will be sent to this email address.
8. Organization President/Chairperson Name

First NameLast Name
9.Organization President/Chairperson Email
example@example.com

Applicant Status and Organization Type
10. Is the applicant an organization or group?
11. Is the organization a registered society in good standing?
12. If not in good standing, please explain:
If the organization is a registered society, a copy of the society’s letter of incorporation must be provided to the Town.
File Upload

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14. Is the organization or group not-for-profit or other?

Other
If other, please explain:

Donation Request Details
16. Is the request for donation of space at a Town facility?
17. If yes, provide the requested dates, description of the space needed, type of event, and any equipment or supplies required:
Please include the requested facility, room, date, time, tables, chairs, audio-visual equipment and any other supplies required..
18. If no, describe the donation request and provide an explanation:
Event, project, or program name
Event date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Event and Funding Information
19. Total cost of event, project, or program
20. Have you received donation or donation in-kind assistance from any other organization, individual, or government agency?
21. If yes, please list all organizations, individuals, and government agencies from which you have received or are about to receive assistance from and specify the dollar value of that assistance.
22. What monies are you or your organization committing or raising towards the event, project, or program you are sponsoring?
Please identify the source and amount of the applicant’s contribution, fundraising or other revenue.
25. Have you previously applied for and been refused a donation or donation in-kind from the Town of Inuvik?
If yes, when?
26. Explanation of previous refusal

Proceeds to Other Groups
27. Will any financial proceeds be donated to other groups or organizations in Inuvik?
28. Donation recipients

Supporting Financial Information
Are the requested financial documents available?
Upload the group or organizations current budget

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Upload the latest audited independent financial statements

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Please explain why the requested financial information is unavailable.

Terms, Declaration, and Signature
Terms and Conditions

Please read the following terms and conditions carefully before submitting your application.
1. In order for the Town of Inuvik to process your application for donation, you may be required to provide the following financial information:
  a) a copy of your group or organization’s current budget; and,
  
  b) a copy of your group or organization’s latest audited independent financial statements prepared by an auditor who is entitled to engage in public practice under the Chartered Professional Accountants Act.
  
  If the information is unavailable, you will provide an explanation as to why.
2. You, your group, or organization agree to abide by and provide the Town of Inuvik with all the necessary information it requires in order to process this application. This includes requested financial information. Any misrepresentation or material omission on this application can result in the application being declined.
3. Applicants requesting donations from the Town of Inuvik that require Council approval under the Donation and Sponsorship Policy shall ensure that a representative is present at the Council meeting to answer questions or provide additional information. Council reserves the right to postpone making a decision until such time as a representative is available to attend.
4. You, your group, or organization will be required to provide the necessary public liability and all perils insurance coverage if required by the Town in order for the Town to provide any donation/donation in-kind assistance for your event, project or program.
5. You, your group, or organization hereby agrees to save harmless the Town of Inuvik from any claim, counter claim, damages, or lawsuit arising from you or your group or organization’s sponsoring of this event, project, or program.
6. I/we agree to provide the Town of Inuvik with a follow-up report if requested.
Applicant's full name

First NameLast Name
Group or organization name
I declare that I have the authority to submit this donation/donation-in-kind application. If applying on behalf of a group or organization, I confirm that I have its approval to submit this application for assistance from the Town of Inuvik.

By signing this application, I confirm that the information provided is complete and accurate and that I have read, understood and agree to the Terms and Conditions outlined above.
Applicant's signature

By signing above, you make the declaration and confirmations stated above.
Date signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: