Community Facility Application Fo

Enhancement Program

Large Funding Stream

Organizations can submit their application in one of two ways:

 By email to: LFP.Application@gov.ab.ca

Or
 By mail to: Alberta Culture and Status of Women
Community Grants
212, 17205-106A Avenue
Edmonton, AB T5S 1M7

*IMPORTANT INFORMATION*

For deadlines that fall on a weekend or statutory holiday applications

will be accepted until the end of the next business day.

Please read the guidelines carefully before beginning the application.

Incomplete applications will not be considered.
Please keep a copy of this application for your records.

August 2021

May 2017

1|P a g e

Classification: Public
 Community Facility Enhancement Program (CFEP)
Large Funding Stream

Section A – Organization Information

Incorporated (Legal) Name of Organization (must match incorporation name):

     
Act the Organization is registered under (see CFEP guidelines section 3.1 for list of all eligible acts):
     

Registration Number:       Registration Date:      

Address of Organization (should match the registered address through incorporation)

     

City: Province: Postal Code: Country:

                       
Mailing Address (*Same as above?) ☐ Yes ☐ No If no, please provide details below
Mailing Address (for Organizations registered outside of Alberta, the address must be Alberta based and regularly monitored by an active
member of the Organization) *NOTE – All correspondence will be mailed to this address

     

City: Province: Postal Code: Country:

                       
Organization Contact Information:
Legal Authorized Signing Authority Contact (must be an Alberta representative’s contact details):
☐ Mr. ☐Mrs. ☐Ms. ☐Other:     
Name:       Organization Position Title:      
Daytime Phone #:       Extension:       Email:      
Primary Application Contact (must be an Alberta representative’s contact details) :
☐ Mr. ☐Mrs. ☐Ms. ☐Other:     
Name:       Organization Position Title:      
Daytime Phone #:       Extension:       Email:      

2|P a g e

Classification: Public
 Section B – Project Overview
Project Title:
     
Brief Project Overview – two to three sentences that concisely describes your project (100 words max):
     
Primary category focus of the project (choose one):
☐Community Services ☐Education ☐Social Services ☐Health ☐Arts

☐Environmental ☐Sports and Recreation ☐Culture ☐Other:      

Project Scope (choose one): ☐Local ☐Provincial ☐National

Project type (choose one):

☐Facility Renovation ☐Facility Construction ☐Capital/Equipment Purchase

☐Assessment/Feasibility Study ☐ Other     

Who will benefit from the project? (choose all that apply):
☐Children ☐Men ☐Seniors ☐Women ☐ Youth

☐General Public ☐Families ☐ Other     

Please list any additional groups that will benefit from the project:      

Project Location (Name of the Facility location for the project or initiative):
     
Address or Legal Land Description required (PO Box addresses will not be accepted):
     
City:       Postal Code:      

Facility Operator (please enter the name of the Organization that operates the facility):

     

Facility Title Holder (please enter the name of the titleholder for the facility or site. A letter of support from the
titleholder must be included if the titleholder is not the applying Organization):

     
If the Organization does not own the facility, please provide the following information:
Term of Lease - Start Date:       End Date      

3|P a g e

Classification: Public
 Option to Renew? ☐ Yes, for       number of years ☐No
Will the capital asset/equipment be owned and operated by the Organization for a minimum of 5 years?
☐ Yes ☐ No (if No, provide details)     

Will the project be carried out by a third party?

☐Yes ☐No (if Yes, provide details)      

Section C – Organization Overview

Summary of the mandate, membership and main activities of your Organization (100 word max):
     
Summary of the programs and/or services your Organization provides to the community (100 word max):
     
What geographical area does your Organization serve?
     
In the last year your Organization has served:
      number of client with       number of paid staff and       number volunteers

Section D – Project Information

CFEP Outcomes are to:
 Enhance the lifespan and support the creation of public-use community facilities.
 Stimulate economic activity in communities across the province.

1. Please summarize your project and demonstrate how it meets the above outcomes:

     

2. Describe your Organization’s experience in carrying out projects of a similar nature or scope:

     

3. What percentage of funding for the project is:

Confirmed:       Pending:       Still to be fundraised:      

4. Are there additional phases planned for the project that will require further funding?

☐ Yes ☐ No (if Yes, provide details)     

5. If your Organization does not receive the full amount of funding requested through CFEP, is the project still viable?
If yes, please explain.

4|P a g e

Classification: Public
      
6. How many people will benefit directly from the project? How is this measured (what is the basis for the figure)?

     

7. Describe any partnerships and/or collaborations for the project:

     

8. What is the anticipated

Start Date:       Completion Date:      

9. Does the facility receive regularly budgeted capital funding from another Government of Alberta funding source?
☐ Yes ☐ No (if Yes please provide details):      

10. Has the Organization applied for, or already received, funding for this project from any other Government of
Alberta funding program?

☐ Yes ☐ No (if Yes please provide details):      

5|P a g e

Classification: Public
 Section E – Budget Template

**Please download, complete and attach Section E Project Budget Template for CFEP Large Funding
Stream**

Budget Template can be found at https://www.alberta.ca/community-facility-enhancement-

program.aspx#jumplinks-5
Section F – 5 Year Operational Budget Template

**Please download, complete and attach Section F Five Year Operating Budget for CFEP Large Funding
Stream**

5 Year Operational Budget Template can be found at https://www.alberta.ca/community-facility-

enhancement-program.aspx#jumplinks-5

Section G – Attachments Checklist

Please check all applicable boxes for the information that has been submitted with the application:

Mandatory information required:

☐Complete sections A through G of the CFEP Large Funding Stream Application Form
☐Financial Statement – signed by two legally authorized representatives of the Organization
☐List of Executives – including names, titles, daytime phone numbers, and email addresses
☐Letter of Support from the Titleholder (when applicable)
☐Estimates, supplier quotations or sources of estimates
☐Donated-in-Kind details, including letters from donors for donated labour, materials, and/or equipment
☐Signed Community Facility Enhancement Program Large Funding Stream Application Declaration
☐Application for Direct Deposit and VOID Cheque
☐Third Party letter (when applicable)

Additional information that may be requested:

☐Letters of support from the community
☐Letter of support from the municipality when applicable
☐Copy of a lease agreement and/or user agreement (when applicable)
☐Feasibility study, business case
☐Current bank statement(s)

6|P a g e

Classification: Public
 Community Facility Enhancement Program Large Funding Stream
Application Declaration

Incorporated (Legal) Name of Organization (“Organization”):

     

*All boxes must be checked to proceed*

I hereby acknowledge that:

☐The information contained in this application and the accompanying documents is true, accurate and complete.
☐I am a representative with designated signing authority/decision-making authority in our Organization.
☐The Organization’s Board of Directors is in full support of this application.
☐I have read the Conflict of Interest section in the Guidelines (11.1 through 11.4) and I am not aware of any conflict
of interest either perceived or apparent in applying for CFEP funding.

☐I understand that should this application be approved, the above identified Organization will be required to enter
into a formal, legally binding agreement with the Ministry that will outline the terms and conditions of the grant.

☐Mr. ☐Mrs. ☐Ms. ☐Other:      

           

Signature of Authorized Representative Date Daytime Phone

                 

Authorized Representative Name (printed) Organization Position Title Email

The personal information that is provided on this application form will be used for the purpose of administering the
applicable grant program and advising the applicant of Community Grants program updates and relevant ministry
initiatives and resources. It is collected under the authority of section 33(c) of the Freedom of Information and
Privacy Act (“FOIP Act”) and is protected by the privacy provisions of the FOIP Act. The FOIP Act applies to any
information that is provided to Alberta Culture and Status of Women. This information may be disclosed in response
to an access request under the FOIP Act, subject to any applicable exceptions to disclosure under the FOIP Act.

Optional:
☐ I agree to allow, Alberta Culture and Status of Women, on occasion, to contact the applicant as identified on this
application form to provide information about ministry initiatives or announcements related to the following topics:
 Grant program changes, funding announcements, and opportunities to provide input/opinion on
programs; and
 Awareness of ministry resources available to the nonprofit sector, including ministry sector events.
7|P a g e

Classification: Public
 8|P a g e

Classification: Public