Funding Request FormFunding Request FormB’nai Brith Calgary Lodge #816 and the Calgary Lodge Menorah Foundation is a grassroots, non-profit organization committed to supporting local agencies that serve individuals who are ill or disadvantaged, and those that provide meaningful programming for children, youth, and seniors. For more than 100 years, the Lodge has proudly provided financial assistance to a wide range of Jewish and non-Jewish community charities. Throughout its history, B’nai Brith Calgary has supported the community during flu epidemics, war bond drives, and human rights initiatives; funded summer camps for children with disabilities; contributed to major health institutions such as the Alberta Children’s Hospital, the Libin Cardiovascular Institute; the Prostate Cancer Centre; supported youth programming and war veterans; donated vehicles to charities serving children with disabilities; and much more. To date, the Lodge has donated over $4 million in support of more than 80 local services.Section 1: General InformationSubmission DateOrganization NameOrganization Type Charitable Non-profitCRA (Charitable Number)AGLC ID NumberMailing AddressAddress Line 1Address Line 2CityPostal CodeProvincePhoneEmailWebsite (if applicable)Have you requested funding from B'nai Brith Calgary before? Yes NoIf Yes, Project Name:Year(s)Amount(s) awarded (per year)$Briefly describe the project outcome(s) or success (maximum 100 words):Optional: Attach any photographs, news articles, etc to illustrate project succcess.Choose File Section 2: Organization Contact PersonFirst NameLast NameTitle/PositionPhone/MobileEmailDescribe organization mission, values, goals and/or objectivesSection 3: Executive SummaryProvide an overview of the funding request, including the amount requested, the purpose of the funding, and the anticipated impact. (maximum 250 words):Section 4: Project/Initiative Description Explain the project or initiative for which you are seeking funding. Include the following details:Project/Initiative TitleProject/Initiative Objective(s)Project/Initiative Scope: Describe the scope of the project/ initiative, including its activities, duration, and community reach:Target Audience/Beneficiaries: Identify the individuals and/or groups who will benefit from the project/ initiative:Provide a timeline for project/initiative completion:Section 5: Describe how the B’nai Brith Calgary gift will be acknowledgedIf the funding request is successful, the B’nai Brith Calgary logo and branding background information will be provided to your organization.Section 6: Proposed Financial BudgetA general outline of costs to complete the project/initiative.Internal FundingOrganization Contribution$Other Contribution$Total Internal Income$External FundingGovernment Contribution$Donor Contribution$Event Contribution$Total Income:$Expenses:Project CostsTotal Expenses$Section 7: Supporting MaterialPlease provide the following supporting information/documents (if applicable): Annual Report and Audited Financial Statement Fundraising ratio Any additional information Annual Report and Audited Financial StatementUpload File Fundraising RatioUpload File Any Additional InformationUpload File Are you prepared, if requested, to appear at a B'nai Brith Calgary meeting to make a presentation and answer questions about your organization and funding request? Yes NoSubmit