Deaf and Hard of Hearing Sport Accessibility Grant Application Form

APPLICATION DEADLINES

Local Club/Community Organization (if applicable)
The local club/community organization must submit the completed application to the respective Provincial Sport Organization (PSO) for endorsement no later than March 22 and/or September 22 annually (if applicable).

Provincial Sport Organizations
The PSO must review, sign, and submit the application to the Sask Lotteries Trust Fund (SLTF) by April 1 and/or October 1 annually.

CONTACT INFORMATION

Club or Community Organization (if applicable)

Contact Name

First Last

Position

Phone

Club or Community Organization Email

Website

Provincial Sport Organization*

Contact Name*

First Last

Position:*

Phone*

PSO Email*

PSO Fiscal Year*

PROGRAM INFORMATION

What is the grant amount being requested?*

(Maximum of $5,000 per initiative)

Please enter a number from 1 to 5000.

Program Name*

Type of program*

Community Program
Provincial Program

What sport(s) will this program involve?*

Will the program be led by a qualified coach or instructor?*

Yes
No

Please provide a brief description of the program.*

How will the program increase sport opportunities for people who are deaf and hard of hearing?*

Program Dates

Start Date: (dd,mm,yyyy)*

End Date: (dd,mm,yyyy)*

Number of Weeks:*

Program Times:*

Location(s)*

Which communities/towns have participants that will benefit from the sport program?*

Indicate the age group(s) your program will be targeting?*

Under 12
13-18
19-54
55+

Estimate the number of athletes, coaches/instructors and officials involved in the program?

Athletes*

Coaches/Instructors*

Officials *

Will there be training, certification, or skill development opportunities offered to:

Coaches/Instructors*

Yes
No

Please explain*

Officials*

Yes
No

Please explain*

Volunteers*

Yes
No

Please explain*

Will you be partnering with any other group, community or organization to offer this program?*

Yes
No

Please explain your answer.*

How will you know if your program is successful?*

(Ex. member survey, number of members, competition results)

Other comments:

FINANCIAL INFORMATION

Please outline all anticipated program revenues and expenses and ensure the budget is balanced.

Note: Financial documentation (receipts) must be provided at the time of the follow-up report. Please refer to the Follow-up Requirements section of the guidelines for acceptable forms of financial documentation.

Revenues

Revenues	Amount

Expenses

Expenses	Amount

Surplus/Deficit

ADDITIONAL INFORMATION

(OPTIONAL)

Please attach any additional information you may have regarding your program such as registration forms, brochures, or advertisements with this application.

Drop files here or

Max. file size: 32 MB, Max. files: 5.

APPLICATION CHECKLIST

Before submitting the application, we recommend your organization complete the following checklist to ensure your application is ready for submission.

I have read the Deaf and Hard of Hearing Sport Accessibility Grant Guidelines.
The application is being submitted prior to the start date of the program or activity.
I have submitted a balanced budget.
I have attached additional information – optional (Ex. registration forms, brochures, advertisements).
The application is complete, signed and dated by the club/community organization (if applicable).
The application is complete, signed and dated by the PSO.

CLUB/COMMUNITY ORGANIZATION DECLARATION

consent 1

I acknowledge that if this application is approved, I will be required to enter into an agreement with the Provincial Sport Organization which will detail the terms and conditions of the grant.

consent 1

On behalf of our organization, I hereby agree that the terms and conditions outlined in the guidelines will be adhered to and the information presented in this application is correct and true.

Club or Community Signing Authority

Name

Title

Date

(dd/mm/yyyy)

After the club/community organization has completed the application form, please send the link to the PSO for their endorsement by clicking on the Save and send link to PSO at the bottom of the form. The PSO will then review and choose to endorse the application and submit it to Sask Sport.

Do not submit the application form. The PSO will submit the application after they add their endorsement.

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About Us

Celebrating Sport

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Member Services

Funding & Recognition

Get Involved

Deaf and Hard of Hearing Sport Accessibility Grant Application Form

APPLICATION DEADLINES

CONTACT INFORMATION

PROGRAM INFORMATION

FINANCIAL INFORMATION

ADDITIONAL INFORMATION

APPLICATION CHECKLIST

CLUB/COMMUNITY ORGANIZATION DECLARATION

PSO DECLARATION