Request form

Please complete this form and click on “Submit your request”. Feel free to attach any additional relevant PDF documents.

1) ADMINISTRATIVE CRITERIA

Only applications that meet all the criteria listed below will be considered. Please confirm that you meet these criteria by checking the appropriate boxes.

Criterion: The applicant organization has official status and registration number as a not-for-profit or public organization, and/or is an Indigenous peoples organization(*)

Yes, we meet this criterion. All administrative criteria boxes must be checked.

Criterion: The beneficiary of the application is a group of individuals (not a single)(*)

Yes, we meet this criterion. All administrative criteria boxes must be checked.

Criterion: The applicant organization demonstrates sound management and can provide audited financial statements upon request(*)

Yes, we meet this criterion. All administrative criteria boxes must be checked.

Criterion: The applicant organization agrees that in exchange for financial support, the MPA may obtain visibility commensurate with its investment(*)

Yes, we meet this criterion. All administrative criteria boxes must be checked.

3) Priority communities, citizen groups and regions

The MPA will prioritize the following communities and citizen groups that the organizations and projects support. Please indicate which community(ies), group(s) and/or region(s) will be supported by your project:

YouthPeople living in poverty and/or homelessnessIndigenous peoples (specifically including our First Nations partners with whom the MPA has a privileged relationship: the Mohawk Council of Kahnawà:ke; the Grand Conseil de la Nation Waban-Aki; and the Huron-Wendat Nation)Communities adjacent to Port facilities in Greater Montreal and the Contrecœur region Invalid Input

4) INFORMATION ON YOUR ORGANIZATION

Official name of the organization(*)

Please enter the name of your organization

Charity registration number(*)

Please enter the Charitable Registration Number

Status(*)

Non-profitPublic organizationIndigenous peoples Invalid Input

Year of registration(*)

Please enter the year of foundation

Do you have a GST/QST number?(*)

YesNo Please indicate if you have a GST/QST number.

GST number(*)

Please enter your GST number.

QST number(*)

Please enter your QST number.

Website(*)

Please enter the website

Brief description/mission of the organization(*)

Please enter a brief description

5) Information on the APPLICANT

Honorific

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First name(*)

Please enter the applicant's first name

Last name(*)

Please enter the applicant's last name

Title(*)

Please indicate the title

Email(*)

Please enter the applicant's email address

Office phone(*)

Please enter the applicant's telephone number

Other phone

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Address(*)

Please enter the applicant's address

City(*)

Please enter the city

Postal code(*)

Please enter the postal code

Province(*)

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Would you be able to provide a main contact person to the MPA for the duration of the project?(*)

YesNo Merci de renseigner tous les champs obligatoires

If the main contact person is not the same person as the applicant, please provide the name here:

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Project description

Name of the project(*)

Please enter the name of the project

Brief description of the project(*)

Please enter the project description

Is this for a donation or a sponsorship?(*)

SponsorshipDonation Please enter the amount requested

Amount requested(*)

Please enter the amount requested

Project date (the date the funds will be used)(*)

Please enter the date the funds will be used

Where will the project be held (region that will benefit or event site)?(*)

Please enter where this project will take place

What previous experience do you have that is relevant to this project?(*)

Please enter your previous experience

What are the social and/or environmental objective(s) of the project?(*)

Veuillez indiquer les objectifs du projet

What visibility do you provide your partners?(*)

Please specify the visibility you offer your partners

7) Project impact

How many people will participate in or be affected by the project?(*)

Please enter the number of people who will participate in this project

What is the expected impact of the initiative?(*)

Please enter the expected impact of the project

If for a donation, will you be able to provide an impact report after the funds are used?(*)

YesNoSponsorship, not donation Please indicate if you will be able to provide the impact report.

If yes, please include the measurable results related to the project objectives that you were able to gather in your impact report.

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When (date)?

Please specify a date

If for a sponsorship, will you be able to provide a report on the visibility achieved after the event?(*)

YesNoDonation, not sponsorship Merci d'indiquer s'il s'agit d'une commandite

If yes, approximately when?

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8) MPA employee engagement

Does the initiative provide an opportunity for MPA employees to participate?(*)

YesNo Please indicate if MPA employees will be able to participate in this project.

If yes, please describe the type(s) and frequency of opportunity(ies) offered

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If yes, please include the nearest location(s) where employees can volunteer for the proposed project, with reference to the MPA offices at 2100 Pierre-Dupuy Avenue, Montreal and/or 3400 Notre-Dame Street East, Montreal

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Would your organization be open to planning and/or adapting volunteer opportunities for MPA employees?(*)

YesNo Invalid Input

Do you have other contributing partners?(*)

YesNo Invalid Input

If yes, please indicate who they are

Please indicate if you have other partners

Does your organization receive a majority of its funding from the government and/or Centraide?(*)

YesNo Merci de renseigner ce champ

Please attach any other relevant PDF document.

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Additional note

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Date(*)

Please indicate the official date of submission of this application.

Request form

Donations and sponsorship

1) ADMINISTRATIVE CRITERIA

2)SUPPORTED SECTORS

3) Priority communities, citizen groups and regions

4) INFORMATION ON YOUR ORGANIZATION

5) Information on the APPLICANT

Project description

7) Project impact

8) MPA employee engagement

Our portals

Request form

Donations and sponsorship

1) ADMINISTRATIVE CRITERIA

2)SUPPORTED SECTORS

3) Priority communities, citizen groups and regions

4) INFORMATION ON YOUR ORGANIZATION

5) Information on the APPLICANT

Project description

7) Project impact

8) MPA employee engagement

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