Community Grant Fund

&

Covid-19 Community Response Fund

Expression of Interest

^* Require fields

Contact First Name *
Contact Last Name *
Name of Organization *
CRA Registered Charity Number *
Address *
City *
Postal Code *
Email *
May we add your Email Address to our mailing list *	Yes  No
Phone *
Website (You must include: http://) *
Name of project *
What is the purpose of your funding request? (75 words or less) *
Is your request for operational support or direct support to your client base? (75 words or less) *
What percentage of the grant request is for the benefit of Port Moody residents ? (75 words or less) *
Estimated number of people that will benefit *
Total budget for project: Do you have other sources of funding? (e.g. Foundations, United Way, Red Cross ) *
Amount secured from Other Sources *
Grant Request (The Foundation will consider requests of $300-$2500) *