Municipal Coal Transition Program Grant Application Form

South Saskatchewan Ready

Municipal Coal Transition Program
Grant Application Form

Important: Please use the Save & Resume feature regularly as you work through the form. Each time you save, a unique resume link will be generated. Be sure to copy, save and email this link to yourself, as it is required to return to your application later.

ELIGIBILITY

Please confirm the following before starting your application.

1. Is your project located in one of the following South Sask Ready communities: Bengough, Coronach, Rockglen, Willow Bunch, RM of Happy Valley, RM of Bengough, RM of Hart Butte, RM of Poplar Valley or RM of Willow Bunch?

Yes

No

Funding is only available for projects located in the South Saskatchewan Ready region.

2. Have you reviewed the Municipal Coal Transition Program funding guidelines?

Yes

No

You must review the funding guidelines before applying.
Click here for South Saskatchewan Ready Municipal Coal Transition Program funding guidelines.

3. Do you understand that, if awarded funding, you will be required to report on the progress of your project?

Yes

No

If your application is successful, reporting on the progress of your project (e.g., updates, number of jobs created, etc) is a requirement.

4. Is your business home-based?

Yes

No

Your project is not eligible at this time.

Please review the South Saskatchewan Ready funding guidelines. Click here for South Saskatchewan Ready Municipal Coal Transition Program funding guidelines.

5. Does your project fall under one of our priority sectors? if so, which sector?

Natural Resources Value-Added Processing

Value-Added Agriculture

Manufacturing

Resource Development

Innovative Technology

Digital Industries

Health/Bio-sciences

Tourism

No, it does not fall under a priority sector.

APPLICANT INFORMATION

Please provide your contact and business information as it appears on your project documentation.

6. Business / Organization Name

7. Applicants First Name

Applicants Last Name

8. Applicant Mailing Address

Mailing Address

City/Town

Province

Postal Code

9. Applicant Physical Address

Street Address or Land Location

City/Town

Province

Postal Code

10. Applicant Phone (This phone number will be used for all correspondence related to this application)

11. Applicant Email (This email address will be used for all correspondence related to this application)

BUSINESS INFORMATION

Please provide a clear overview of your business or organization.

13. Name and Position of Representative Responsible for the Project

14. Name(s) and Positions of Principal Members (if applicable):

15. How many years has your business been established?

16. How many people are currently employed by your business?

Employment Type	Number of Employees

17. How many additional jobs will this project create within the next 2 years?

Employment Type	Number of Employees

PROJECT INFORMATION

Please provide a clear overview of your project.

18. Will this project increase the municipal tax base?

Yes

No

19. Will your project negatively impact other businesses in the region?

Yes

No

If yes, please describe the potential negative impact.

20. What is the total cost of your project? (Please note: The total project cost must equal combined total of SSR funding requested and all other funding sources.)

21. How much funding are you requesting from South Saskatchewan Ready (SSR) for this project? (Please note: All amounts entered should be before tax. Funds distributed do not include tax.)

22. What portion of the project costs will be covered by other sources (e.g., personal funds, private investors, bank loans or other funding programs)?

Personal Investment

Private Investment

Bank Loans

Other Funding Sources

No Other Funding Sources

Total Amount of Personal Investment:

Total Amount of Private Investment:

Total Amount of Bank Loans:

Total Amount of Other Funding Programs:

PROJECT INFORMATION CONTINUED

Please provide a clear overview of your project.

23. Provide an overview of your project.

24. Describe the key activities involved in the project.

25. How will the funding contribute to the start-up or expansion of your business?

26. What impact will the project have on the region as a whole?

27. What is the expected project completion date?

28. Project Expenses: Please list each expense separately in order of priority (most important to least important). (Please note: All amounts entered should be before tax. Funds distributed do not include tax. Quotes are required for each expense.)

Expense Item:	Expense Amount:	Expense Purpose:

File Upload: Please upload all quotes related to this project expenses listed above. (Please note: Estimates are not accepted. All submissions must include formal, itemized quotes from suppliers.)

Choose File

29. Have you attached all required quotes necessary for this application? (Please note: Estimates are not accepted. All submissions must include formal, itemized quotes from suppliers.)

Yes

No

Applications will not be reviewed until all required quotes are attached..

DECLARATION

Please check that the information provided in this application is accurate and complete.

30. Is this part of a multi-staged project?

Yes

No

Describe future plans or subsequent phases.

31. Do you intend to proceed with the project if you do not receive SSR funding?

Yes

No

32. Is all of the information in this application accurate and complete to the best of your knowledge?

Yes

No

Please confirm the information is accurate before submitting this application.

33. Applicant Signature (By typing your full name, you are providing your electronic signature)

34. Date

I certify that the information provided in this application is accurate and complete.