Sample application form


Please refer to the Application Guidelines when filling out this application.

  • We encourage you to use plain language and to be as concise as possible. To this end, we have limited the number of words you can populate in sections. Please respond to questions within the space and word limits requested.
  • The proposal and budget request should be accurate, brief, and clear, keeping in mind that members of the Community Investment Committee will have varying degrees of familiarity with the work of your organization.
  • Typical grants range from $25,000-$50,000 to a maximum of $100,000.

SECTION 1: ORGANIZATION PROFILE

Name of Organization /Institution

(If applying from a research institution, please include the name of your department). This is the organization that will receive the funds and be responsible for the project.

What best describes your organization?

Registered charity
Research Institution
Not-for-profit organization (not registered as a charity)

Your organization must fit into one of these categories. If you have further questions regarding eligibility, please contact cip@cira.ca.

What best describes your Internet project? (pick one)

Please note that we do not support projects solely focusing on website development and design.

Online services
Digital literacy
Governance
Technology

Infrastructure
Surveillance/privacy/security
Policy making or political processes
Other _____________________

Incorporation or charitable registration number

Year of incorporation or registration

Mailing Address

  • Address
  • City
  • Province
  • Postal Code

Website Address

Contact Person Name for this grant

This is the lead person who will be most familiar with the project and who is best positioned to answer questions about the project. This is the person who will receive various communications related to the application and selection results.

  • Title
  • Relationship to the Organization
  • Email
  • Telephone
  • Fax

Organization’s Annual Operating Budget (not necessary for Universities) $

Fiscal Year End

Have you applied for a CIP grant before?

yes
no

Have you received a CIP grant before?

yes
no

(If yes) Have you submitted your final report yet?

yes
no

Applicants who click no will not be permitted to continue

 

If you received 25% less funding than requested, what impact would that have on your project?

Please describe how the scope of your project might change.


SECTION 2: SUMMARY

Title of proposal

Briefly, describe:

Your organization (limit 100 words)

You may include such information as your mission, mandate and purpose.

Your proposed initiative (limit 200 words)

Briefly describe your goals, what you want to do and how you will accomplish it. Provide details of the impact that your initiative will have on your organization and on the community. Clearly state how it fills a gap – outline the problem(s) it will solve, and/or the need it meets.

If this is part of a larger project, be specific about the portion for which you are requesting funding.

For more information, visit the Project planning tool and Measuring results tip sheet.

Who will benefit and how (limit 100 words)

Describe who will benefit from your initiative. State your expected results, in terms of what you want to accomplish.

Please summarize your initiative in one or two concise sentence(s). (50-60 words) This plain language summary will be available to the public if your proposal is approved.

This project will help build a better online Canada by:

What sets you apart from others doing this kind of work? (limit 100 words)

Describe how you are uniquely qualified to conduct this work, based on your background and experience.

Start date

When you anticipate beginning your project. This date should not precede the grant approval date.

End date

When you anticipate your project to be completed. A final report on the project will be due three months from this date.

Amount requested $

Should be the same amount as what you show as a source of revenue from CIRA on the budget sheet.

Total Initiative Budget $

The total amount of the project. Should be the same as the total revenue and total expenses on the budget sheet.

 

When the budget amount requested differs from the total, please identify additional sources of funding and state whether the amount(s) is/ are confirmed or contingent upon receiving funding. (limit 100 words)

Are there partnerships and/or unique collaborations with other organizations that are involved in the initiative? If so, what is the scope and nature of these collaborations? (limit 100 words)


SECTION 3: MISSION ALIGNMENT

1. How does your project align with the goals and priorities of CIRA's Community Investment Program?(limit 150 words)

Use this section to link your project to the goals and priorities of CIRA's Community Investment Program.


SECTION 4: ACTIVITIES & OUTPUTS

1. Please outline specific key activities for the initiative. Briefly list some of the primary activities, events or milestones of the initiative, along with the outputs you will produce during the grant period. Be realistic about your goals as you will be required to report on all key activities. Include estimated start and end dates for each.(limit 250 words)

In reading this section, the Committee should get a clear picture of how you will get the work done. List your key activities, events or milestones. You may add a few details under each of these. You should not exceed 5-7 key activities.

Example:
1. Planning and creation of formal governance model and operations manual:

  • Start date: MM/DD/YYYY, End date: MM/DD/YYYY
  • Research other similar community engagement models
  • Gather information on operations and programming systems
  • Establish and document a coherent governance model and operations manual

SECTION 5: OUTCOMES

1. For online services projects: By the time the initiative is complete, what deliverables, outputs and outcomes will you have achieved? How will you measure your outcomes both qualitatively and quantitatively, in both the short and long term? Why do these services need to migrate online?

Be specific and as realistic as possible as you will be asked to report on your success in achieving these results. (limit 300 words)

How will you know you’ve accomplished what you wanted to? Outcomes are often shown in terms of performance indicators. Identify things that will show you are achieving the results you are planning. How will this effect people, processes, and services?

For more information, visit the Project Planning tool and Measuring Results tip sheet.

a) For research institution applications:
How will your project advance your field of work and the Internet in Canada? (limit 100 words)

2. For digital literacy projects: By the time the initiative is complete, what deliverables, outputs and outcomes will you have achieved? How will you measure these outcomes both qualitatively and quantitatively, in both the short and long term? How will this help the communities you are trying to reach? Please explain what makes this project different from other digital literacy projects.

Be specific and as realistic as possible as you will be asked to report on your success in achieving these results. (limit 300 words)

How will you know you’ve accomplished what you wanted to? Outcomes are often shown in terms of performance indicators. Identify things that will show you are achieving the results you are planning. How will this effect people, processes, and services?

For more information, visit the Project Planning tool and Measuring Results tip sheet.

a) For research institution applications:
How will your project advance your field of work and the Internet in Canada? (limit 100 words)

3. For infrastructure and technology projects: By the time the initiative is complete, what deliverables, outputs and outcomes will you have achieved? How will you measure these outcomes both qualitatively and quantitatively, in both the short and long term? How will this project advance the Internet’s technology and infrastructure in Canada?

Be specific and as realistic as possible as you will be asked to report on your success in achieving these results. (limit 300 words)

How will you know you’ve accomplished what you wanted to? Outcomes are often shown in terms of performance indicators. Identify things that will show you are achieving the results you are planning. How will this effect people, processes, and services?

For more information, visit the Project Planning tool and Measuring Results tip sheet.

a) For research institution applications:
How will your project advance your field of work and the Internet in Canada? (limit 100 words)

4. For privacy/surveillance, governance, and policy-related projects: By the time the initiative is complete, what deliverables, outputs and outcomes will you have achieved? How will you measure these outcomes both qualitatively and quantitatively, in both the short and long term? How will this project advance Internet privacy, governance and/or policy-related issues in Canada? Be specific and as realistic as possible as you will be asked to report on your success in achieving these results. (limit 300 words)

How will you know you’ve accomplished what you wanted to? Outcomes are often shown in terms of performance indicators. Identify things that will show you are achieving the results you are planning. How will this effect people, processes, and services?

For more information, visit the Project Planning tool and Measuring Results tip sheet.

a) For research institution applications:
How will your project advance your field of work and the Internet in Canada?(limit 100 words)

5. For other projects: By the time the initiative is complete, what deliverables, outputs and outcomes will you have achieved? How will you measure these outcomes both qualitatively and quantitatively, in both the short and long term? Be specific and as realistic as possible as you will be asked to report on your success in achieving these results. (limit 250 words)

How will you know you’ve accomplished what you wanted to? Outcomes are often shown in terms of performance indicators. Identify things that will show you are achieving the results you are planning. How will this effect people, processes, and services?

For more information, visit the Project Planning tool and Measuring Results tip sheet.

a) For research institution applications:
How will your project advance your field of work and the Internet in Canada? (limit 100 words)


SECTION 6: ENGAGEMENT AND OVERSIGHT

1. Who in your organization is responsible for the direct oversight of this initiative? What are their qualifications for managing this kind of work? (limit 100 words)

In this section you will show that you are engaging the right people and skill sets for your project. It also gives you an opportunity to show how you are engaging citizens, volunteers and others in your project.

2. Will you engage external personnel or others (e.g. volunteers, consultants, designers, other researchers, faculty or students) in this initiative? If so, what skills or qualifications will they require? (limit 100 words)


SECTION 7: SUSTAINABILITY

1. Beyond this grant, how will you sustain and build upon what you achieved? How will you financially sustain it? (limit 150 words)

2. How will this initiative strengthen your organization’s ability to achieve its mission? (limit 150 words)


SECTION 8: RECOGNITION

1. If this grant application is approved for funding, how will you recognize CIRA's Community Investment Program? (limit 150 words)

Simple forms include the use of our logo on your website and in any published materials about your project, mentions in media relations, social media and events. Further guidance on this will be provided in your agreement.


SECTION 9: GRANT OPPORTUNITY AWARENESS

How did you hear about CIRA’s Community Investment Program: (select all that apply)

A colleague or friend
Another applicant
CIRA staff member or Community Investment Committee member
Member email from CIRA
Other email from CIRA
Email from third party − third party ______________________
Media article − name of publication ______________________
Facebook
Twitter
LinkedIn
Internet research − search term ______________________
Other, please describe ______________________


Detailed Budget

Please complete the Excel budget template attachment found in the online application system. List all revenue sources for the initiative as well as all expenses. Total expenses must equal total revenue.

Provide budget notes within the budget sheet to help explain the costs, for example: program coordinator salary ($5,000 = 200 hours over 20 weeks X $25/hr.). Include in-kind support costs. These should be reasonable and in line with acceptable costs in this sector. Get quotes for any items or services to be purchased, and while you do not have to provide these when you submit your application, we may ask for them at a later date.

Also, the financial ask should be proportionate to the size and capacity of your organization.


This application was authorized by:

Name

Title (i.e. Executive Director/ President/Chair, Board of Directors)

Signature

Signature will be taken electronically.

By checking the following boxes, I declare the following:

I am authorized to approve this application for funding and its associated budget.

I have reviewed the contents of the application and provided my approval.

Date