Project Proposal

PROJECT or ACTIVITY SUBMISSION FORM

Please use this form to submit your proposal to the Greater Nipissing Stewardship Council online. Thank you.

If you have additional supporting documentation, please complete and print your form and mail to: The Greater Nipissing Stewardship Council, PO Box 1391, 101 Worthington St. E., North Bay ON P1B 8K5

Click here to print the form.

First Name: *

Last Name: *

Affiliation

Address line 1 *

Address line 2

City *

Province/State *

Postal Code (no spaces) *

Phone *

Email address

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PROJECT / ACTIVITY PROPOSAL NAME: *

Brief description about your proposal [objective(s), desired outcome(s)]: *

0/100 words

Type of Project: (check off all applicable boxes) *

Ongoing	New
Single Year	Multi-Year

Anticipated Start Date: * +

Completion Date: +

IN-KIND Support Being Requested (funding applications, administrative, professional/technical, marketing, etc.): *

	Proponent	GNSC	Other Partner(s)	Other Funder(s)
$$ or %	Proponent	GNSC	Other Partner(s)	Other Funder(s)

Please enter "0" in fields not applicable.

FUNDING Support Being Requested: *

	Proponent	GNSC	Other Partner(s)	Other Funder(s)
$$ or %	Proponent	GNSC	Other Partner(s)	Other Funder(s)

Please enter "0" in fields not applicable.

Estimated TOTAL Cost: *

Other Partner(s) and/or Funder(s). Please specify

0/40 words