Community Support Application

Organization Name *

Organization Type *

Primary Contact Name *

Title/Role *

Email *

Phone

Community/municipality served

Briefly describe your organization’s mission and activities *

Type of request *

Initiative/event/campaign name *

Start date

End date

Amount Requested ($) *

Community/municipality Title/Role request

Receipts or invoices required:

Project Summary *

Describe the initiative, who it serves, what will happen, and why support is needed.

Community benefit & local impact *

Describe who benefits, expected outcomes, local impact, and why Synergy North’s funding matters to project success.

Payment Information *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Supporting Documents

Drag & Drop Files, Choose Files to Upload

Examples: event deck, campaign materials, budget, annual report, partnership letters, sponsorship package.

If you have questions about the program or application process, please contact:

Lesley Racco
Public Relations & Communications
lracco@synergynorth.ca