Sample application form

This is a copy of the form you will see in our online application system. If you wish, you can use this as a reference to prepare your submission offline, cutting and pasting your answers into the online form when you are ready.

• SECTION 1: Organization profile
• SECTION 2: Project summary
• SECTION 3: Alignment
• SECTION 4: Beneficiaries
• SECTION 5: Project plan
• SECTION 6: Budget
• SECTION 7: Community Support
• SECTION 8: Outcomes and Sustainability
• SECTION 9: Recognition
• SECTION 10: Grant opportunity awareness

Please refer to the Application Guidelines when filling out this application.

We encourage you to be concise and use plain language. To assist you, we have set word limits for each section. The proposal and budget request should be accurate, brief and clear, keeping in mind that members of the Community Investment Evaluation Panel will have varying degrees of familiarity with the work of your organization. Grants are available up to $100,000.

SECTION 1: Organization profile

Name of Organization / Institution

This is the organization that will receive the funds and be responsible for the project. If you are applying from a university or college, please include the name of your department.

Organization Type:

• Not-for-profit organization (not registered as a charity)
• Registered charity
• University or college
• First Nations, Métis and Inuit communities

Your organization must fit into one of these categories. If you have further questions regarding eligibility, please contact [email protected].

Incorporation or charitable registration number:

Year of incorporation or registration:

Mailing Address:

• Address
• City
• Province
• Postal Code

Website Address:

Contact Person Name for this grant

This is the lead person who will be most familiar with the project and who is best positioned to answer questions about the project. This is the person who will receive various communications related to the application and selection results.

• Title
• Relationship to the Organization
• Email
• Telephone

About Your Organization

Briefly describe your organization including such information as your mission, mandate and purpose. Limit 100 words.

Organization’s Annual Operating Budget (not necessary for Universities and Colleges) $

Fiscal Year End:

Have you applied for a CIRA Grant before?

yes
no

Have you received a CIRA Grant before?

yes
no

(If yes) How much did you receive?

(If yes) Have you submitted your final report yet?

yes
no

Applicants who click no will not be permitted to continue.

SECTION 2: Project summary

Project title:

Which funding area best describes your internet project?

• Infrastructure
• Online Safety
• Policy Engagement

Project Summary (limit 200 words)

Briefly describe the problem or opportunity your project intends to address, what you will do, who will benefit, and the expected results.

One-Line Description (limit 40 words)

Please summarize the gist of your project in one sentence.

Open Source

CIRA requires that outputs produced through projects funded by the Community Investment Program be open and available for anyone to use, share and build upon. Please indicate if you are able to meet this requirement if your project is selected for funding. (limit 100 words)

• Yes / No
• Please explain your answer. (If yes, how; if no, please explain why)

Start date

When you anticipate beginning your project. This date should not precede the grant approval date, expected during July 2023.

End date

When you anticipate your project to be completed. A final report on the project will be due three months from this date.

SECTION 3: Alignment

How well does your project align with the overall aim of CIRA’s Net Good program? Limit 100 words.

CIRA’s Net Good grants fund innovative community internet projects to build a resilient, trusted and secure internet for all Canadians.

In your response, please show how your project aligns with this aim, giving specific reference to the funding area you are applying for:

• Infrastructure: CIRA aims to increase the number of Canadians who have access to a high-quality and high-performing internet.
• Online Safety: CIRA is focused on increasing Canadians’ cybersecurity knowledge and safety from threats. We want more Canadians to know how to protect themselves and feel safe online.
• Policy Engagement: CIRA engages, supports and strengthens a vibrant and influential Canadian internet community. We seek a legislative and policy environment that favours a trusted internet for Canadians.

SECTION 4: Beneficiaries

Describe who will benefit from your initiative and how they will benefit. Please explain your implementation relationship with the beneficiaries and how the project was conceived. Limit 100 words.

Preference is given to initiatives that benefit:

• Northern, rural and Indigenous communities
• Students (K-12 and post-secondary)

Please identify the number of beneficiaries you intend to reach in any of these target groups relevant to your project:

Students in kindergarten to grade 12:

Post-secondary students:

People in Northern communities:

People in rural communities:

People in Indigenous communities:

People in urban communities:

Please explain how you arrived at these numbers (limit 100 words):

Please identify any other target groups you are aiming to reach and the number of intended beneficiaries in each. Limit 100 words.

SECTION 5: Project plan

Please outline specific key activities for the initiative. Include events or milestones, along with the outputs you will produce during the grant period. Be realistic as you will be required to report on all key activities. Include estimated start and end dates for each. In reading this section, the Panel should get a clear picture of how you will get the work done. You should not exceed 5-7 key activities. Limit 250 words.

Example Activity:
1. Needs Assessment: Start 07/15/2022 – End 09/15/2022

• Form a needs assessment committee
• Establish enrollment requirements or prerequisites for potential participants
• Determine and set the priorities for 5 workshops
• Develop course curriculum and create orientation pamphlet
• Prepare a management plan for coordinators, volunteers and participants

Output: Training implementation plan

Qualifications

Please describe your organization’s unique qualifications to deliver this project, including reference to:

• Project management personnel, skills and/or resources you will draw on internally or externally
• Projects of a similar scale to this request that your organization has managed in the past

Limit 100 words

SECTION 6: Budget

CIRA welcomes projects where financial contributions are sourced from multiple sources, including in-kind contributions by the project applicant.

Amount Requested

• Should be the same amount as the amount shown as a source of revenue from CIRA on the budget sheet.

Total Initiative Budget

• The total cost of the project. Should be the same as the total expenses on the budget sheet.
• Please identify the specific costs (line items) for which you are requesting funding from CIRA.

If the Amount Requested differs from the Total Initiative Budget, please identify the source(s) of additional funding and current status (confirmed or pending). For any pending amounts, please indicate the likelihood of being realized. Limit 100 words.

Detailed budget

Please complete the Excel budget template attachment found in the online application system. List all revenue sources for the initiative (including co-funding from other sources and in-kind contributions) as well as all expenses. Total expenses must equal total revenue.

Provide budget notes within the budget sheet to help explain the costs, for example: program coordinator salary ($5,000 = 200 hours over 20 weeks X $25/hr.). Include in-kind support costs. These should be reasonable and in line with acceptable costs in this sector. Get quotes for any items or services to be purchased, and while you do not have to provide these when you submit your application, we may ask for them at a later date.

Also, the financial request should be proportionate to the size and capacity of your organization. You can download the Excel budget template here.

SECTION 7: Community Support

Please describe how your project engages with and involves the local community – from conception to execution. This can include reference to surveys, consultations, committees, partnerships, financial contributions – any forms of participation. Please also characterize the key community participants.

Limit 200 words.

SECTION 8: Outcomes and Sustainability

Through its grants, CIRA is seeking outcomes in the following areas. Please indicate the results you expect to achieve in the areas relevant to your project.

Enter numbers only, no commas or other special characters.

Infrastructure:

• Number of communities reached:
• Number of people reached:
• Number of research reports produced:

Online Safety:

• Number of research reports produced:
• Number of educational frameworks produced:
• Number of training programs developed:
• Number of people trained:
• Number of people protected:

Policy Engagement:

• Number of events or conferences convened:
• Number of people in attendance at events or conferences:
• Number of research reports produced:

Other Measures

Please describe any other quantitative or qualitative measures you are planning to track. Limit 100 words.

Specific Results

Please describe the specific changes you expect to result from your initiative – whether at the individual, group, organizational, community or institutional level. (limit 100 words):

Please describe the longer-term impact you expect from this project. (limit 100 words):

Sustainability

Please describe how you will sustain what you achieve through this project, after the grant is finished. Limit 100 words.

For research institution applications: How will your project advance your field of work and the Internet in Canada? Limit 100 words.

SECTION 9: Recognition

Selected grant recipients are required to acknowledge funding from CIRA.

If this grant application is approved for funding, how will you recognize CIRA’s support? Limit 100 words.

Simple forms include the use of our logo on your website and in any published materials about your project, mentions in media relations, social media and events. Further guidance on this will be provided in your agreement.

SECTION 10: Grant opportunity awareness

How did you hear about CIRA’s Community Investment Program Grants: (select all that apply)

A colleague or friend
Another applicant
CIRA staff member or CIRA board member
Member email from CIRA
Email from third party − third party: ______________________
Media article − name of publication: ______________________
Social media (Facebook, Twitter, LinkedIn, etc.) _____________
Internet research − search term ______________________
Other, please describe ______________________

This application was authorized by:

Name

Title (i.e. Executive Director/ President/Chair, Board of Directors)

Signature

Signature will be taken electronically.

By checking the following boxes, I declare the following:

I am authorized to approve this application for funding and its associated budget.

I have reviewed the contents of the application and provided my approval.