Club Assistance Program (CAP) Application

If your programs require funding support, consider the Club Assistance Program with the goal of increasing participation.

NOTE: Information collected on this form is directly related to, and is necessary for, the administration of the BCDSF Club Assistance Program. Please fill out all the information.

Contact Information

Name of your Organization *

Address

Address Line 1

Address Line 2

City

--- Select state --- AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonProvince

Postal Code

Phone

Email *

Website

Name of Organization's President/Chair

First

Last

Name of person submitting application

First

Last

Email of person submitting application *

Project Information

Amount Requested *

• up to $1,000
• $1,001 - $2,000

Will participants be charged a program registration fee? *

• Yes
• No

How long is the project duration?

• Days
• Weeks
• Months

How many sessions will be offered?

Target group of participants (by age and gender, check all that apply)

• Womens/Girls
• Men/Boys
• Seniors
• Children/Youth
• Adults
• Any age group

Target group of participants (check all that apply)

• Deaf
• Hard of Hearing
• Hearing
• CODA

Do any of the following targets apply? (Check all that apply)

• Aboriginal
• Youth at risk
• New Immigrants
• Northern BC (BC Zones 7-8)

Would your program include a long-term athlete development?

• Yes
• No

See long-term athlete development page for details.

Which LTAD stage? (Check all that apply)

• Active Start (Age 0-6)
• FUNdamentals (Age 6-9)
• Learn to Train (Age 8-12)
• Train to Train (Age 11-16)
• Train to Compete (Age 15-23+)
• Train to Win (Age 21+)
• Active for Life (Any age)

What type is this program?

• Camp
• Clinic
• Workshop
• Deaf Family Event
• Sport Event
• Other (please specify in goal)

What is the goal of this program?

Who will this program be hosted by? *

• Club
• Sport organization
• School
• BCDSF
• Other

Name of chairperson of the program *

First

Last

Names of committee members

What sport or recreation locations have been arranged or looked into for this program?

Have you partnered with any sports groups, government agencies, local businesses for this program? If yes, please specify which ones.

Who is responsible for booking the sport/recreation location?

What is the deadline for booking?

Who is responsible for the distribution of information regarding the program (i.e. flyer)?

When is this information to be distributed by?

Who is responsible to follow up with athletes who are interested in the program?

How many registrations are needed for this program to go ahead?

When should this person have followed up with all athletes interested?

Profit Loss Budget

NOTE: Fill in the projected revenues/expenses as needed, otherwise leave as blank.

Revenue

Contribution from your club/organization

Other Income (Please specify from where and how much)

Partner contribution

Profits from fundraising

Registration fees ____ X number of participants ____ =

Amount requested from the BCDSF grant

Total Revenue *

Expenses

NOTE: Please use Sports Interpreting Services form for grant to book interpreters.

Coaches fee

Deaf peers

Chairperson/Honrarium fee

Filming expenses (to be posted on BCDSF vlog)

Course/Workshop fees

Course materials

Supplies/Equipment for the Program

Food & drinks provided

Room Rental (i.e. gym, multipurpose room)

Equipment rental

Transportation

Other (please specify what and how much)

Total Expenses *

Profit/Loss *

I understand that I must give BCDSF office a full report including the number of participants, their status (member of BCDSF or not) and the financial information of the program within 30 days of the program's completion. *

• I accept
• I decline

I understand that my organization/club is not qualified for the next CAP grant offering until a full report has been completed and given to the BCDSF office. *

• I accept
• I decline

Submit