Special Project Continued Funding Application Form Special Project Continued Funding Application Form Special Project Continued Funding Form If you are human, leave this field blank. Identification Official Name of the Special Project * Program Coordinator's name * First Name --- Last Name Program Coordinator's phone # * Contact Person's name * First Name --- Last Name Contact Person's phone # * Fax number Email address * Mailing address * City or Town * Province Saskatchewan Alberta British Columbia Manitoba New Brunswick Nova Scotia Newfoundland & Labrador Northwest Territories Ontario Quebec Postal code * Pending approval, funding cheque is: Payable to Mailed to City or Town * Province Saskatchewan Alberta British Columbia Manitoba New Brunswick Nova Scotia Newfoundland & Labrador Northwest Territories Ontario Quebec Postal code * Special Project Information Special Project Purpose/Objectives Include a description and executive summary of activities. History of the Special Project This special Project directly benefits: Self-declared Indigenous students New Canadian students (5 years or less) Small community or rural students Students facing socio-economical barriers Estimated number of participants Would you like SMEA promotional materials at your Special Project? yes no If so, please select from the following SMEA membership brochures SMEA promotional banners Would you like your Special Project to be advertised in SMEA weekly online publication eNOTZ? yes no Please provide your advertisement text below Optionally, attach a document with this text instead Drop a file here or click to upload Choose File Maximum upload size: 5MB Special Project Budget Expenditures Clinician Costs Refer to suggested guidelines Professional * Student * Total Clinician Fees Travel Mileage ($0.42/km) Accommodation Taxi Parking Other Total Travel Expenses Breakfast Breakfast Lunch Supper Other Total Meal Expenses Administrative Expenses Promotional/Printing Supplies Transportation Costs Other Total Administrative Expenses Special Project Budget Income Registration Refer to suggested guidelines Student * Adult * Other * Total Registration and Fees Travel Mileage ($0.42/km) Accommodation Taxi Parking Other Total Travel Expenses Breakfast Breakfast Lunch Supper Other Total Meal Expenses Administrative Expenses Parent Association School Division Other Total Grants Administrative Expenses Facilities Clinician Supplies Other Total Donations Other income Other income Self-Generated Income Requested Income Total Income Certification I hereby affirm that I am a member of SMEA in good standing. All eligibility requirements for Special Project Status have ben met and this application, inclusive of all sections above, constitutes a correct and true statement. I further certify that the attached signed financial statement for the current fiscal year is a correct and true statement. Signature of applicant * Position If you require assistance or additional information, please contact the Saskatchewan Music Educators Association office at (306) 256-7187. Applications can be scanned and emailed to smea@sasktel.net or mailed to: The Saskatchewan Music Educators Association Box 632 Cudworth, SK. S0K 1B0 The information requested is information that SMEA is required to submit to Saskatchewan Lotteries Trust. reCAPTCHA Submit
