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,i THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON REPORT �C)#e 1 Meeting: General Purpose and Administration Committee File q � Monday, January 18, 1999 Date: Res. #G,P0 - CD-3-99 Report #: APPLICATIONS FOR THE ADVANCE FUNDING By-law # Subject: PROGRAM - ONTARIO LOTTERY CORPORATION It is respectfully recommended that the General Purpose and Administration Committee recommend to Council the following: 1. THAT Report CD-3-99 be received; 2. THAT Council consider all submitted grant requests for the Provincial Advanced Funding Program; 3. THAT a copy of Council's decision and all applications approved for funding be forwarded to the Ontario Lottery Corporation for direct payment; and 4. THAT all applicants be advised of Council's decision. 1.0 BACKGROUND 1.1 Report CD-39-98 was submitted and approved by Council on September 14, 1998. (Copy attached as Schedule 1). 1.2 The Clerk's Department subsequently corresponded with eligible organizations in Clarington advising of Council's decision and the requirements of the Ontario Lottery Corporation for funding eligibility. Report CD-3-99 - 2 - January 18, 1999 2.0 APPLICATIONS FOR ADVANCED FUNDING 2.1 Thirty applications were received which met the deadline of November 27, 1998. One application was received on November 30, 1998. A summary of the applications is attached as Schedule 2. In an effort to reduce paper and copying costs, these applications and related documentation have been circulated to Council as Schedule 3 under separate cover. 3.0 PROVINCIAL GUIDELINES FOR APPROVAL OF APPLICATIONS 3.1 The Ontario Lottery Corporation has set the following guidelines for Municipalities to follow when determining whether to approve advance funding. 1. Organizations that conducted Monte Carlo events during the period from January 1, 1996 to March 31, 1998. In order to minimize the impact on charities which have made financial commitments based on the funds they raised through roving Monte Carlo events, municipalities should ensure that these organizations are given priority for advance funding. To facilitate the priority requirement, the applicant organization must provide its Group Identification Number (GIN#) and evidence of conducting a Monte Carlo event during the period from January 1, 1996 to March 31, 1998 (e.g. a copy of the lottery licence). No local organization has held a roving Monte Carlo event. 2. Size and budgetary needs of the organization Access to the advance funding should be allocated based on the budgetary needs of the organization. Municipalities should review the budgets of each applicant organization to evaluate the funds required by the organization to provide charitable services against funds from other sources. Groups which justify a definite need for advance funding should take precedence over those with operating surpluses. 7u2 • Report CD-3-99 - 3 - January 18, 1999 Copies of the current financial statements and current and previous years' budgets must be supplied with the first application for advance funding to assist in making this determination. 3. Services provided to the community Municipalities may base decisions on the benefit the services of the organization provide to the community when deciding whether to grant access to advance funding. 3.2 A document entitled "Advance Funding Program Questions and Answers" formulated by the Ontario Lottery Corporation is being provided as Schedule 4 to assist Members of Council in their deliberations to allocate individual grants to a total amount of $223,883.00. This amount has been approved by the Province for the Municipality of Clarington. i 3.3 The financial data of each application has been reviewed by the Treasury Department. 4.0 RECOMMENDATIONS It is therefore recommended: 1. THAT Report CD-3-99 be received; 2. THAT Council consider all submitted grant requests for the Provincial Advanced Funding Program; 3. THAT a copy of Council's decision and all applications approved for funding be forwarded to the Ontario Lottery Corporation for direct payment; and Iu3 J Report CD-3-99 -4 - January 18, 1999 4. THAT all applicants be advised of Council's decision. Respectfully submitted, Reviewed by, atti rri , A.M.C.T. Franklin Wu, M.C.I.P., R.P.P. `tea icipal Clerk Chief Administrative Officer MPKS*PLB*hj Attachments: Schedule 1 — Report CD-39-98 Schedule 2 — Summary of Applications Schedule 3 —Applications and related documentation (circulated under separate cover) Schedule 4 —Advance Funding Program Questions and Answers I Interested Parties: Ontario Lottery Corporation Association of Hospital Volunteers Advance Funding Program 47 Liberty Street South Suite 800 — 70 Foster Drive Bowmanville, Ontario Sault Ste. Marie, Ontario L1C 2N4 P6A 6V2 Bethesda Cemetery Bethesda House of Mercy 7762 Old Scugog Road 141 Liberty Street South Enniskillen, Ontario P.O. Box 82 LOB 1JO Bowmanville, Ontario L1C 3K8 Big Brothers of Clarington Bowmanville Eagles Junior Hockey Association 23 Scugog Street 4215 Tooley Road Bowmanville, Ontario Courtice, Ontario UC 3H7 LIE 1Z4 Clarington Concert Band Clarington Girls Hockey Association P.O. Box 337 85 Queen Street Orono, Ontario Bowmanville, Ontario LOB 1MO L1C 1M5 / u4 Report CD-3-99 - 5 - January 18, 1999 Clarington Minor Hockey Clarington Older Adult Association Association 26 Beech Avenue P.O. Box 191 Bowmanville, Ontario Bowmanville, Ontario L1C 3A2 L1C 3K9 Clarington Swim Club Inc. Durham East 4H Council 83 Mearns Court 1246 Prestonvale Road Bowmanville, Ontario Courtice, Ontario L1C4N4 UE 2N9 Haydon Community Centre Orono Amateur Athletic Association 7762 Old Scugog Road 2 Princess Street Enniskillen, Ontario Orono, Ontario LOB 1 JO LOB 1 MO �I Rotary Club of Bowmanville Solina Community Centre Board P.O. Box 217 1914 Concession Road 6 Bowmanville, Ontario Hampton, Ontario L1C3K9 LOB 1J0 The Visual Arts Centre of Alzheimers Society of Durham Clarington 419 King Street West, Suite 205 143 Simpson Avenue Oshawa, Ontario P.O. Box 52 L1J 2K5 Bowmanville, Ontario L1C 3K8 Autism Society Ontario Big Sisters of Oshawa-Whitby-Clarington 1 Greensboro Drive 555 Wentworth Street East Suite 306 Oshawa, Ontario Etobicoke, Ontario L1 H 3V8 M9W 1 C8 Canadian Cystic Fibrosis Canadian Diabetes Association 181 Fallingbrook Street 909 Simcoe Street North, #2 Whitby, Ontario Oshawa, Ontario L1 R 2131 UG 4W1 Catholic Family Services of Durham Region Community Care Durham Association 670 King Street East 419 King Street West, Suite 605 Oshawa, Ontario Oshawa, Ontario L1H 1G5 L1J 2K5 / u5 r Report CD-3-99 - 6 - January 18, 1999 Grandview Children's Centre Kawartha Child Care Services 600 Townline Road South 201 Antrim Street Oshawa, Ontario Peterborough, Ontario Ll H 7K6 K9H 3G5 Kinark Child and Family Services Rehabilitation Foundation for the 240 Duncan Mill Road Disabled Operating as Ontario March Suite 402 of Dimes Don Mills, Ontario P.O. Box 2220 M3B 3B2 Oshawa, Ontario L1 H 7V5 I Saint Elizabeth Health Care The Canadian Red Cross Society 209 Dundas Street East 419 King Street West Suite 303 Suite 115 Whitby, Ontario Oshawa, Ontario L1N 7H8 L1J 2K5 The Community Foundation of Ontario Lung Association Durham 40 King Street West Box 336 Suite 202 8 Midtown Drive Oshawa, Ontario Oshawa, Ontario L1 H 1A4 L1J 81-2 u6 Schedule 1 THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON REPORT Meeting: GENERAL PURPOSE AND ADMINISTRATION COMMITTEE File # -VC)c ' - 60 Date: August 31, 1998 Res. #G Q q-ggb-9 Report #: CD-39-98 By-law # Subject: ADVANCE FUNDING PROGRAM—ONTARIO LOTTERY CORPORATION It is respectfully recommended that the General Purpose and Administration Committee recommend to Council: 1. THAT Report CD-39-98 be received; 2. THAT the Municipality of Clarington participate in the Advance Funding Program and that funds be distributed to eligible chanties by the Ontario Lottery Corporation; 3. THAT a processing fee of$25.00 be charged by the Municipality to the applicant organizations which are eligible for funding; 4. THAT a deadline of November 27, 1998, be established for receipt of applications; and 5. THAT the roster of the applications be submitted to the General Purpose and Administration Committee for approval on January 18, 1999. BACKGROUND The following resolution was passed by Council on July 13, 1998: "THAT the correspondence dated June 24, 1998, from Garth Manness, President, Ontario Lottery Corporation advising of the details of the Advance Funding Program, be received; and THAT the correspondence be referred to the Clerk's Department for review and preparation of a report to be submitted to the General Purpose and Administration Committee." This correspondence is attached hereto as Schedule"A" and is summarized below. • An Advance Funding Program has been set up to advance funds to help charities during the transition time until charity casinos are set up. These funds will be recovered from the charities' share of table game proceeds from the charity casinos once they are set up and collecting money. The Municipality of Clarington has been allocated$223,883 and this has been confirmed with the Province. 7 Report CD-39-98 -2- August 31, 1998 • Clarington Charities which have held Monte Cado events between January 1, 1996 and March 31, 1998,will be given first priority to access these funds. • Funding should be allocated based on the budgetary needs of the organization, i.e.groups which justify a definite need for advance funding should take precedence over those with operating surpluses. • All applicants must complete the subscribed application form and provide the following documentation: Governing documents - Revenue Canada Registration Number(if applicable) - Detailed outline of Programs/Services - Operating Budgets for current and last fiscal year - List of Board of Directors • Municipalities may set an administrative fee for processing applications on a cast recoverable basis. • Each municipality is responsible for submitting a roster of eligible local charities along with the appropriate documentation to the Ontario Lottery Corporation. The completed roster and documentation must be accompanied by a Council resolution which approves the recommended funding. • The advance funding program will cease on March 31, 1999. To allow the organizations as much time as possible to compile and co-ordinate the documentation required by the Province, Staff suggests a deadline of Friday, November 27, 1998 for submission of the applications to the Municipality. The date of January 18, 1999, is being recommended for the consideration of the roster of applications by the General Purpose and Administration Committee to allow Staff enough time to receive, verify and process the applications and prepare the material for submission to the General Purpose and Administration Committee subsequently to the Ontario Lottery Corporation. RECOMMENDATIONS It is therefore recommended: 1. THAT Report CD-39-98 be received; 2. THAT the Municipality of Clarington participate in the Advance Funding Program and that funds be distributed to eligible charities by the Ontario Lottery Corporation; 3. THAT a processing fee of$25.00 be charged by the Municipality to the applicant organizations which are eligible for funding; Report CD-39-98 -3- August 31, 1998 4. THAT a deadline of November 27, 1998, be established for receipt of applications; and 5. THAT the roster of the applications be submitted to the General Purpose and Administration Committee for approval on January 18, 1999. Respectfully submitted Reviewed by Itti a .C.T. W.H. Stockwell r Chief Administrative Officer MPK/PLBmj ■rl\, 6kOntario Lottery Corporation Soci6t6 des loteries de I'Ontario Advance Funding Program Charity Roster Liste des organismes vis6s - Programme d'avances de fonds Municipality/ Municipality: 10402 Clarington (T) Allocation /Versement: $ 223,883 Page _of/ de Please Type or Print Cleady/Veuillez dactylographier ou dcnie an lettres moulees GIN# NIG INCORPORATED OR LEGAL NAME RAISON SOCIALE FULL MAILING ADDRESS ADRESSE POSTALE COMPLETE (Street address, CiV Province, Postal Code) (rue, villa, province, code postal) CONTACT PERSON PERSONNE-RESSOURCE TELEPHONE/TELEPHONE ADVANCE $ DE L'AVANCE FOR OLC USE ONLY NE RIEN ECRIRE ICI $ ( $ ( ) $ ( ) $ ( ) $ ( ) ( ) TOTAL OF ABOVE ADVANCES(not to exceed Total Allocation for Munlcipallty) TOTAL DES AVANCES CI-DESSLIS(no dolt pas d6passer Is montant octroy4 h Is municlpalit4) $ Municipal Approval /Approbation de la municipality: The undersigned, having full municipal authority, approves this roster of charities recommended for Advance Funding: Le soussigne, fonds de pouvoirs de to municipalite,approuve In presente/late d'organismes de charite pour lesquels une avance de fonds est recommandee: (Date) (Name)/(Nom) (Signature) ( (Telephone)/(Telephone) ADVANCED FUNDING x w C r ORGANIZATION HOME BASE AMOUNT REQUESTED GRANT AMOUNT 1 Association of Hospital Volunteers Clarington $ 9,600.00 2 Bethesda Cemetery Clarington $ 25,000.00 3 Bethesda House of Mercy Clarington $ 50,000.00 4 Big Brothers of Clarington Clarington $ 95,000.00 5 Bowmanville Eagles Junior Hockey Association Clarington $ 60,000.00 6 Clarington Concert Band Clarington $ 17,000.00 7 Clarington Girls Hockey Association Clarington $ 10,000.00 8 Clarington Minor Hockey Association Clarington $ 50,000.00 9 Clarington Older Adult Association Clarington $ 80,500.00 10 Clarington Swim Club Inc. Clarington $ 14,887.00 11 Durham East 4H Council Clarington $ 5,000.00 12 Haydon Community Centre Clarington $ 50,000.00 13 Orono Amateur Athletic Association Clarington $ 50,000.00 14 Rotary Club of Bowmanville Clarington $ 50,000.00 15 Solina Community Centre Board Clarington $125,000.00 16 The Visual Arts Centre of Clarington Clarington $ 14,253.00 x w C r r, v 2 APPLICATION RECEIVED LATE — November 30, 1998 31 1 Ontario Lung Association Oshawa 1 $ 25,000.00 ORGANIZATION HOME BASE AMOUNT REQUESTED GRANT AMOUNT 17 Alzheimer Society of Durham Oshawa $ 10,000.00 18 Autism Society Ontario Etobicoke $? 19 Big Sisters of Oshawa-Whitby- Clarington Oshawa $ 38,000.00 20 Canadian Cystic Fibrosis Whitby $? 21 Canadian Diabetes Association Oshawa $ 2,370.00 22 Catholic Family Services of Durham Oshawa $ 20,000.00 23 Durham Region Community Care Association Oshawa $ 14,000.00 24 Grandview Children's Centre Oshawa $ 35,000.00 25 Kawartha Child Care Services Peterborough $ 5,000.00 26 Kinark Child and Family Services Don Mills $ 11,119.00 27 Rehabilitation Foundation for the Disabled Operating as Ontario March of Dimes Oshawa $ 7,000.00 28 Saint Elizabeth Health Care Whitby $? 29 The Canadian Red Cross Society Oshawa $ 25,842.00 30 The Community Foundation of Durham Oshawa $180,000.00 APPLICATION RECEIVED LATE — November 30, 1998 31 1 Ontario Lung Association Oshawa 1 $ 25,000.00 Schedule 4 ADVANCE FUNDING PROGRAM QUESTIONS AND ANSWERS 1. Is the roster that we are to prepare and submit to OLC to incorporate only those charities that our Council recommends receive funding or is it to incorporate all organizations filing applications with the municipality? The municipality has the authority to decide which charities end up on the roster, and how much they will be allocated. Council may choose to include all charities that apply, or only certain groups. At the end of the process, municipal officials must feel satisfied that they have approved a roster that reflects local needs. We have asked that you give first consideration to charities that have been funded in the past through Monte Carlo events. 2. Where can charities apply? To their home base municipality or to any municipality in which they have been licensed over the past three years? We have had charities apply to Richmond Hill that have never run Monte Carlos in our Town but rather in area municipalities. Charities can apply to the municipality in which the charity resides, and also to any municipality which has licensed them to operate games in that municipality in the past. Council can also consider charities that they feel have provided significant services in the community in the past but may not have operated licensed fundraising activities. 3. We are to consider those charities previously licensed for Monte Carlos over all other organizations. What if the previously licensed Monte Carlo charities are not able to demonstrate"local" need and other charities can demonstrate more of a local need? Do we bump the Monte Carlo charities? The guidelines indicate that charities which have held Monte Carlo events in the past are to be given priority consideration by the municipality. The guidelines also indicate that a municipality is to consider a charity's request for funding based on local needs and priorities. The final decision rests with the municipality which may decide to include other charities ahead of Monte Carlo charities. 4. You could potentially have 20 charities apply to have their names placed on the roster. If the OLC is to verify placement, who is ultimately responsible for the list, the respective municipalities or the OLC? The OLC will review the rosters to ensure eligibility of charities, and to ensure consideration was given to Monte Carlo charities. The OLC cannot make any changes to an approved municipal roster. However, should the OLC have any questions about placement, or should it be determined that a charity(s) does not meet the eligibility Advance Funding Program Questions and Answers Revised: August 26,1998 Page] / L requirements, the OLC will notify the municipality which will then make adjustments to the roster as required. 5. How do we determine share for each charity given that priority will be given to those previously licensed for Monte Carlos? Previously licensed Monte Carlo charities do not need to supply anything other than GIN# and a copy of a previous event license. All other charities are required to provide a significant amount of information including how any funds advanced will be used. If it is our job to determine allocation based on local need, how can we do this if we don't have complete packages from all organizations? The municipality is required to determine share for each charity. If the municipality feels it requires more information from a charity(s) in order to conduct a fair assessment, then it is well within their right to as for such information. 6. We have heard that this is in fact a grant and not a loan. Is this correct? If it is a grant, perhaps there will be wider spread interest amongst the charities to apply. The Advance Funding Program is in fact a grant program. Charities will not be required to repay the money. 7. Is there a deadline in OLC's mind that they would like applications in by? The sooner that completed rosters and applications are received by the OLC, the sooner they can be reviewed, and the sooner the allocation can be disbursed to charities. Although the program ends on March 31, 1999, it is advisable for municipalities not to wait until the last possible moment. Monte Carlo charities have been without a regular source of revenue since March 31 of this year. Also, if many municipalities wait until the last minute to submit their rosters, sheer volume will result in delays in processing. Municipalities can set their own deadline for receiving the applications from charities, to ensure they have enough time to process them and send us the roster. Some municipalities in fact have taken out advertisements advising charities to have their applications in by a certain date. 8. What is the administrative fee for and what, if anything are other municipalities charging? Municipalities can charge an administrative fee to charities to cover the costs of any additional resources required to fulfill their obligations in this program. This fee should be set on a cost-recovery basis only. This fee is consistent with the fee a municipality can charge a charity to process and issue a charitable gaming license. Advance Funding Program Questions and Answers Revised: August 26,1998 Page 2 ILL 9. Who determines eligibility --the respective municipalities or the OLC? All charities may be eligible but do not demonstrate local needs and this can be true of formerly licensed Monte Carlo charities. Do we not submit those applications that we deem ourselves not to be eligible? The municipality will determine eligibility based on local needs. The charities are required to provide the municipality with documentation that indicates they are a bona fide charity. After that, the municipality will decide which charities, including Monte Carlo charities, go on the roster based on need. 10 What about organizations that extend services across the Region and not solely in one municipality (i.e. United Way of York Region). How do we deal with an application from this organization? These organizations are bound by the same rules that apply to all other charitable organizations -- they can apply both in their host municipality, and any other municipality in which they have been licensed for charitable games, or can prove they have provided significant services in the community. In the case of an umbrella group like the United Way, many of its member agencies have held licensed games in the past, and in turn, they may apply to their home municipality as well as to any municipality in which they have held licensed games in the past. 11. How are municipalities handling notification to charities of this program? We are aware of what Newmarket has done. What are other municipalities doing and what deadlines are being established? Newmarket has set the end of September for receipt of applications. Several municipalities, like Newmarket, have gone this route. It is well within the right of a municipality to advertise the program and publicise the deadline for applications to be received. 12. Are all municipalities going forward to their respective Councils for approval to the recommended share of funding for each charity? A completed roster requires municipal approval, be this by Council resolution or appropriate municipal endorsement. As an example, council may authorize senior staff or a council cub-committee to review and approve the roster. 13. What about charities and/or their umbrella groups applying to this or other municipalities? In order to be fair to all charities, shouldn't we be aware of applications being submitted to other municipalities for the same charity? Perhaps there should be a questions on the application asking the charity if they have applied to other municipalities, and if so, where? Advance Funding Prog a i Questions and Answers Revised: August 26,1998 Page 3 / L3 It is the responsibility of the municipality to determine share for each eligible charity placed on the roster. It is well within the right of the municipality, in the interest of fairness to all charities, to request whatever information it requires from a charity in order to make a proper decision on share. 14. Does the OLC want all of the supporting documentation from charities or simply our rosters? As stated in the package sent to you dated June 24, 1998, rosters complete with the required municipal approval, the applications for all charities listed on the roster, and the supporting documents for those applications, are to be submitted to OLC. 15. Will the Province distribute funds once the rosters and applications are approved, or will the municipalities be provided with the monies for distribution? The OLC will distribute the money directly to charities once the rosters and applications have been approved. 16. For those charities previously licensed with the Province for Monte Carlos, will the Province provide us with financial statements, accounts of money raised by the charity in our municipality and how the funds were disbursed within our municipality? It is the Province that receives some or all of this information from charities conducting Monte Carlos - not the municipalities. It is the responsibility of the municipality to determine the share of funds for each charity. In order to make a fair and informed decision, it is well within the right of the municipality ro request whatever supporting documentation from a charity it deems necessary to achieve this. Advance Funding Program Questions and Answers Revised: August 26,1998 Page 4 L4 Schedule "A" Ontario Lottery Corporation COUNCIL DIRECTION D_1 Societe des loleries de I'Onfariri �It I (�r,� 70 Faster Drive {i' I`�Il➢ Sane 800 Sault Ste Marie,Ontario PGA 6V2 JUL — 3 1998 70,Promenade Faster Bureau 800 .',1uNAEAPALITY OF CIARINGTON Sault Ste.Marie(Ontario) P6A 6V2 ,r, MAYOR'S OFFICE Tel 705 946-6464 a Fax.705 946-6600 June 24, 1998 Dear Head of Municipal Council: As indicated in the letter to Heads of Municipal Council from Chris Hodgson, Chair of Management Board of Cabinet, dated April 9, 1998, this letter is to advise you of the details of the Advance Funding Program. The Province of Ontario is making up to $40 million in interim financing available in fiscal 1998/1999 for distribution to charities. The funds will be distributed to charities by the Ontario Lottery Corporation (OLC). Each municipality has been allocated a per capita share of the advance funds to allocate to local charities based on local priorities. Your municipality's share is indicated on the attached roster. Each municipality is responsible for completing a roster of local charities to share in the advance funding. Charities must apply to their municipality for inclusion on the roster. Application and roster forms from which additional copies can be made are attached. For charities to participate in the Advance Funding Program, they must meet the same requirements for eligibility as set out in the Lottery Licensin.- Policy Manual provided by the Alcohol and Gaming Commission of Ontario to your local licensing or clerk's office. Applying charities that have held Monte Carlo events in your municipality from January 1, 1996 to March 31, 1998 are to receive priority placement on the roster. OLC will verify this placement upon receipt of all documentation, as indicated below. In developing the roster, municipalities will also recommend the share of the advance funding allocation each charity is to receive. If a local charity casino/casinos becomes operational prior to March 31, 1999, the advance funding will be discontinued as local charities begin to access charity casino proceeds directly. The advance funding program will cease on March 31, 1999. /2 1 ' J F p ' GuIDELINES �J ry GUIDELINES FOR MUNICIPALITIES (Including First Nation Reserves) TO DETERMINE CHARITY ACCESS TO ADVANCE FUNDING I. Eligible charitable organizations wanting to access advance funding may do so by applying to their local municipality. 2. Organizations that were previously licensed to conduct Monte Carlo events must provide their Group Identification Number(GIN#) assigned by the Alcohol and Gaming Commission of Ontario (AGCO) and printed on all gaming event licences, and evidence of conducting a Monte Carlo event during the period from January 1, 1996 to March 31, 1998 (e.g. a copy of the lottery licence). All other applicants must include with their application for advance funding the following: / • Governing Documents: Articles of incorporation,letters patent, by-laws,constitution,charter, trust deed, memorandum/articles of association,sinned as required. • Revenue Canada Notification of Registration Letter: If the organization is registered. • Detailed outline of programstservices: What they are, how delivered to clients,specific costs, supporting materials, benefits to the municipality,etc.(i.e_any information that will assist in determining charitable nature of the objects and purposes). r• Organization's operating budgets for current and last fiscal year: Detailing other sources of funds and how any funds advanced will be used. Organization's financial statements for last fiscal year. ' List of Board of Directors. 3. Aunicipalities will receive and review the applications for eligibility and will ensure that only fully completed applications are sent to the Ontario Lottery Corporation (OLC). Charitable organizations must meet the eligibility requirements set out in the AGCO Lottery Licensing Policy Manual. Each municipality may set an administrative fee for this service on a cost recoverable basis. 4. For charity access to the Advance funding, each municipality is responsible for submitting a roster of eligible local charities to the OLC. This roster should be developed based on local needs and priorities. Municipalities will recommend the share of their per capita allocation of the advance funding each charity is to receive. 5. A council resolution or appropriate municipal authority approval of the completed roster is to accompany the roster and charity applications submitted to the OLC. oicW mr cssost Continued on bock l 13 O.IMO I artery CaperlNO.• swew Ne,Iw.n..e.ro.r.Ne Please see attached page of instructions. 10 roster 0riee.Suite 800 Sault Ste.Marie.ONlado _ please print or type — P&A6V2 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? F-1 No 0 Yes(Ifyes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name I Street address of organization i city Prbvince Postal Code Telephone No. Fax Nu. I Mailing address(d o fifeter1) Posizi Code b) Is your organization incorporated as a non-profit organinlion? No Yes(11 yes) Jurisdiction of Incorporation number Incorporation c) Is your organi;_auon registered as a Charitable Oroanization with Revenue Canada? CNo u Yes (I/ps) Revenue Canada Reg number l I I I I I I of Roo long has your organization existed? What is the financial y-r end of your organization Month I Day Years 3. Affiliates Is your oreanization affiliated with any corporation or organization? ❑No Yes H yes- List the legal Nacres(A'tz.5 separate sheet if necessary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet UnCOssary) xJ b) C) d) Oaesiians? Cali 1-600-387-0098 etc fAP 001(3✓n5) 1 Confinuecf on bock ,. .,w...n..r.-wii...n.w+.�:MWMwur 'f�.+w:�.aw•+asuu.�..•e-..u,%F.ww-�,>..�ti..M'..'lFe� .+.n.+vn':°:n.a.��.�..rw.:nva:.• Orb.b l°tlery Cp-.n.tlo. APPLICATION CHECKLIST Organisations that were previously licensed to conduct Monte Carlo events must provide their Group Identification Number (GIN#) assigned by the Alcohol and Gaming Commission of Ontario (AGCO) and evidence of conducting a Monte Carlo event during the period from January 1, 1996 to March 31, 1998 (e.g. a copy of the lottery licence). All other applicants must include with their application for advance funding the following: ❑ Governing Documents: Articles of incorporation, letters patent,by-laws,constitution, charter, trust deed, memorandum articles of association, signed as required. ❑ Revenue Canada Notification of Registration Letter: If the organization is registered. ❑ Detailed outline of programs/services: What they are, how delivered to clients, specific costs, supporting materials, benefits to the municipality, etc. (i.e. any information that will assist in determining charitable nature of the objects and purposes). ❑ Organization's operating budgets for current and last fiscal year: Detailing other sources of funds and how any funds advanced will be used. ❑ Organization's financial statements for last fiscal year. ❑ List of Board of Directors. The above items must be enclosed with your application and returned: (a) to your municipal office—it your charitable organization is local=J in a city,town, township, or village; (b) to your local band office—it your charitable organization is IccEed on a First Nation reserve; or, (c) to the Ontario Lottery Corporation—if your charitable organization is located in an unorganized area. Only those charitable organizations located in an unorganized area are to send their applications directly to the-Ontario Lottery Corporation, Advance Funding Program. Conti.nu°don occ:: olc tan W3(M5) ; . 7 a: Advance Funding Program Charity Roster Liste des organismes vises - Programme d'avances de fonds Municipality I Municipality: 10402 Clarington (T) Allocation / Versement: $ 223,883 Page 4—of/de Please Type or Pnnt Clearly/Veuillez dactylographier ou genre en leares moulks GIN# NIG INCORPORATED OR LEGAL NAME RAISON SOCIALE FULL MAILING ADDRESS ADRESSE POSTALE COMPLETE (Street address, City, Province, Postal Code) (rue, ville,province, code postal) CONTACT PERSON PERSONNE-RESSOURCE TELEPHONE/TELEPHONE ADVANCE $ DE UAVANCE FOR OLC USE ONLY NE RIEN ECRIRE ICI Association of Hospital 47 Liberty Street South $5,000.00 Volunteers Bowmanville, LIC 2N4 President ( 905 ) 623-2407 $5,000.00 Enniskillen, LOB WO Secretary/Treasurer ( ) -2 $25,000.00 P.O. Box 82, Bowmanville Chair, Brd of Dir. LIC 3K8 ( ) - $20,000.00 LIC 3H7 Executive Director $5,000.00 President ( 4 1 A ) r-i i Hockey zuaa 2tra0. __ _Bever! "argusen $5,000.00 on r s _- Association --85 Bowmanville, LIC 1115 President ( ) TOTAL OF ABOVE ADVANCES(not to exceed Total Allocation for Munlclpallty) TOTAL DES AVANCES CI-DESSUS(ne dolt pas d6passer le montant octroy6 a la municipailte) $ Municipal Approval/Approbation de la municipality: The undersigned, having full municipal authority,approves this roster of charities recommended forAdvance Funding: Le sousslgnd, fondd de pouvoirs de la munkippalitd,approuve(l�a prrdsente-lllste d'organismes de charit€pour lesquels une avance de fonds est recommandde: Ai It 1 N�lniiT- �tflo F-7 tatur lephone)/(TAI6phane (Date ) v � Advance Funding Program Charity Roster Liste des organismes vis6s - Programme d'avances de fonds Municipality/ Municipalite: 10402 Clarington (T) Allocation /Versement: $ 223,883 Pase of/do Please Type or Print Clearly/Veuillez dactylographier ou ecnre an lettres moul6es GIN* NIG INCORPORATED OR LEGAL NAME RAISON SOCIALE FULL MAILING ADDRESS ADRESSE POSTALE COMPLETE (Street address, City, Province, Postal Code) (rue, villa,province, code postal) CONTACT PERSON PERSONNE-RESSOURCE TELEPHONE/TELEPHONE ADVANCE $ DE UAVANCE FOR OLC USE ONLY NE RIEN ECRIRE ICI CMS1456 Clarin ton Minor Hockey P.O. Box 191 Mickey Cryderman $5,000.00 Association Bowmanville, L1C 3K9 Treasurer ( 905 ) 623-6360 Clarin ton Older Adult 26 Beech Avenue Bowmanville Donald Welsh $20,000.00 Association L1C 3A2 President ( 905 ) 697-2856 Clarington Swim Inc, owmanvil a Wendy McConnell $ 5,000.00 L1C 4N4 President ( 905 ) 697-3124 Durhnm Fngr AH Council 1946 Prpsronunlp Road Mary Ann Found $ 2,500.00 Courtice, L1E 2N9 Director -- ( ) $ 7,500.00 Enniskillen, LOB 1JO Treasurer ( ) $ 45,000.00 Association LOB IMO President ( ) 983-5584 TOTAL OF ABOVE ADVANCES(not to exceed Total Allocation for Municipality) TOTAL DES AVANCES CI-DESSUS(ne dolt pas d6passer Is montant octroy6 3 Is municipalit6) $ Municipal Approval /Approbation de la municipality: The undersigned, having full municipal authority,approves this roster of charities recommended forAdvance Funding: Le souss/gne, fonde de pouvoirs de/a munfnfc/pa/ltd,approuvre+Is presente liste d'organismes de cheritd pour lesquels une avance de fonds est recommendee: ( te) (Na / Nom) (Sign lure) (Telephone)/(TfIdph v Advance Funding Program Charity Roster Liste des organismes vis6s - Programme d'avances de fonds Municipality / Municipality: 10402 Clarington (T) Allocation /Versernent: $ 223,883 Page_3_of/de ZL- Please Type or Pnnt Clearly/Veuillez dacry/ographier ou dcrire an lettres moul6es FULL MAILING ADDRESS CONTACT PERSON ADVANCE FOR OLC GIN* NIG INCORPORATED OR LEGAL NAME RAISON SOCIALE ADRESSE POSTALE COMPLETE (Street address, City, Province, Postal Code) (rue,ville,province, code postal) PERSONNE-RESSOURCE TELEPHONE/TELEPHONE $ DE UAVANCE USE ONLY NE RIEN ECRIRE ICI Rotary Club of Bowmanville P.O. Box 217, Bowmanville Harry Cooke L1C 3K9 Treasurer $5,000.00 ( 905 ) _623-5474 Solina Community Centre Board 1914 Concession Road 6 Deanna MacDuff $45,000.00 ( 905 ) 263-8386 The Visual Arts Centre of 143 Simpson Avenue Michael Sullivan _ $ 13,883.00 L1C 3K8 (905 ) 697-3736 BSC1296 Big Sisters awa- t - 555 Wentworth Street East Joanne Howsam $ 1,000.00 (905 ) 725-9300 GRCO219 ' 600 Townling Road South Harold Whitbread Oshawa, L1H 7K6 Chair, Bd of Dir $ 5,000.00 (905 )571-0515 Kinnrk rhilri and Family 240 Dimpnn M411 Road Neville Jones $ 2,000.00 Services _ Suite 402, Don Mills Director, Finance M B 3B2 (416 ) 391-3884 TOTAL OF ABOVE ADVANCES(not to exceed Total Allocation for Municipality) TOTAL DES AVANCES CI-DESSUS(ne dolt pas depasser Is montant octroy6 i Is municipallt4) $ Municipal Approval/Approbation de la municipality: The undersigned, having full municipal authority,approves this roster of charities recommended forAdvance Funding: Le sousslgne, fonddi de pouvoirs de la munkiipalltti,approuve Is presente Ilste d'organlsmes de charite pour lesque/s Una avance de fonds est recommendee: RIF_ 24 kcwr�"lE y (D jog (Telephone) one ate) me'/Ctn IJ Advance Funding Program Charity Roster Munirinali}v / Munirinallfk• 1ndn9 Clarinaton ITl Liste des organismes visds- Programme d'avances de fonds ' , ........_.r....., ..._..._.�_..___ ._ .__ _-__._.- . , Allocation /Versement: $ 223,883 Page of/de Please Type or Pnnt Clearly/Veuillez dactylographier ou Acrire an/awes moul4es GIN# NIG INCORPORATED OR LEGAL NAME RAISON SOCIALE FULL MAILING ADDRESS ADRESSE POSTALE COMPLETE (Street address, City,Province,Postal Code) (rue, villa,province, code postal) CONTACT PERSON PERSONNE-RESSOURCE TELEPHONE/TELEPHONE ADVANCE $ DE UAVANCE FOR OLC USE ONLY NE RIEN ECRIRE ICI CRC1891 The Canadian Red Cross 419 King Street West Donna Vandertuin $2,000.00 Suite 115, Oshawa, L1J 2K5 Branch Manager ( 905 ) 723-7251 TOTAL OF ABOVE ADVANCES(not to exceed Total Allocation for Municipality) TOTAL DES AVANCES CI-DESSUS(ne dolt pas d6passer Is montant octroyd a la municipality;) [$223,883.00 Municipal Approval /Approbation de la municipalitE: The undersigned, having full municipal authority,approves this roster of charities recommended for Advance Funding: Le soussigne, fonde de pouvoirs de Is municlpalltg,approuve la presente Iiste d'organismes de charlt6 pour lesquels une avance de fonds est recommandAe: D� P1 )/l (+t-r �raa� c9e23 /l' lDa e) )/(No Nom � ure) (Te1eph6ne)1(T61Qphone)' EM j" THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON Memorandum FILE Co?""y To Mayor and Members of Council From: Marie P. Knight Stanley, Deputy Clerk Date: January 8, 1999 Subject: SCHEDULE 3 TO REPORT CD-3-99 — GPA — JANUARY 18, 1999 APPLICATIONS FOR ADVANCED FUNDING I attach herewith 31 Applications for Advanced Funding and related correspondence. We have not copied the volume of paper work received with the applications for costs saving purposes. However, this documentation is available in the Clerk's Department for your review. The applications have been numbered for your ease of review and discussion. Please note that Application #28 — St. Elizabeth Health Care, is incomplete. A letter was forwarded and several telephone calls were made to this organization advising of the deficiencies but no response was received to meet the deadline of November 27, 1998. It should be noted that although the Province has advised that: "...organizations wanting to access advance funding may do so by applying to their LOCAL municipality," it is left at the discretion of Council whether or not a grant is approved depending on how much the local municipality benefits from the efforts undertaken by the applicant organization which does not have a home base in Clarington. Respectfully submitted, Marie P. night tanley, C. .0., CMM II Deputy Clerk MPKS/hj cc: F. Wu, Chief Administrative Officer P. Barrie, Municipal Clerk M. Marano, Treasurer Department Heads (memo only) ADVANCED FUNDING ORGANIZATION HOME BASE AMOUNT REQUESTED SURPLUS 1 Association of Hospital Volunteers Clarington $ 9,600.00 $ 7,290.00 2 Bethesda Cemetery Clarington $ 25,000.00 $ 2,947.87 3 Bethesda House of Mercy Clarington $ 50,000.00 $ 25,749.00 4 Big Brothers of Clarington Clarington $ 95,000.00 $ 16,273.00 5 Bowmanville Eagles Junior Clarington $ 60,000.00 ($ 5,153.64) Hockey Association 6 Clarington Concert Band Clarington $ 17,000.00 $ 4,471 .07 7 Clarington Girls Hockey Clarington $ 10,000.00 $ 1,596.60 Association 8 Clarington Minor Hockey Clarington $ 50,000.00 ($20,474.00) Association 9 Clarington Older Adult Clarington $ 80,500.00 $ 36,760.00 Association 10 Clarington Swim Club Inc. Clarington $ 14,887.00 $ 12,807.20 11 Durham East 4H Council Clarington $ 5,000.00 $ 4,976.33 12 Haydon Community Centre Clarington $ 50,000.00 $ 2,611.88 13 Orono Amateur Athletic Clarington $ 50,000.00 $ 45,000.00 Association 14 Rotary Club of Bowmanville Clarington $ 50,000.00 $218,485.38 15 Solina Community Centre Board Clarington $125,000.00 $ 52,961.05 16 The Visual Arts Centre of Clarington $ 14,253.00 $ 10,774.00 Clarington 2 APPLICATION RECEIVED LATE — November 30, 1998 31 Ontario Lung Association Oshawa 1 $ 25,000.00 ? ORGANIZATION HOME BASE AMOUNT REQUESTED SURPLUS 17 Alzheimer Society of Durham Oshawa $ 10,000.00 $ 16,906.00 18 Autism Society Ontario Etobicoke ? $ 142,470.00 19 Big Sisters of Oshawa-Whitby- Clarin ton Oshawa $ 38,000.00 $100,137.00 20 Canadian Cystic Fibrosis Whitby ? $ 3,181.00 21 Canadian Diabetes Association Oshawa $ 2,370.00 $ 96,356.00 22 Catholic Family Services of Durham Oshawa $ 20,000.00 $ 513.00 23 Durham Region Community Care Association Oshawa $ 14,000.00 ($ 55,375.00) 24 Grandview Children's Centre Oshawa $ 35,000.00 $ 40,000.00 25 Kawartha Child Care Services Peterborough $ 5,000.00 $124,763.00 26 Kinark Child and Family Services Don Mills $ 11,119.00 ($450,086.00) 27 Rehabilitation Foundation for the Disabled Operating as Ontario March of Dimes Oshawa $ 7,000.00 $683.317.00 28 Saint Elizabeth Health Care Whitby ? $110,825.00 29 The Canadian Red Cross Society Oshawa $ 25,842.00 $ 0 30 The Community Foundation of Durham Oshawa $180,000.00 $ 53,489.00 APPLICATION RECEIVED LATE — November 30, 1998 31 Ontario Lung Association Oshawa 1 $ 25,000.00 ? APPLICATION #1 CHARITY ROSTERAPPLICATION ADVANCE FUNDING O°1M°L°Ihry C=Mh°e "°fNut)nmS°,IeBOO ° Please see attached page of instructions. FosrerWivz.Suue 900 P 9 .,zuR sie.Marie.Owan, ,09A 61/2 - Please print or type - 1. Previous charitable gaming licence FOR OFFICE USE ONLY: Has your organization ever applied for a charitable gaming event licence? il'7 1 No Yes (it yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two (2)years? No Yes 2. Information on organization GIN a) Incorporated or legal name k0 tI A�T 10 ry of �IOSW1GiL ✓OLD � — 3orJMANrrf►LE I I I I I I Street address of organization Ci Province ,+7 1W 64 -T'1 6T 41if. �cSasTN 40W f/A/Whtt.Vc Ory Postal Code Telephone No. Fax No. All L .'t Irk Mailing address lildifferent) Postal Code 1 ' b) Is your organization incorporated as a non-profit organization? K No Yes(If yes) Jurisdiction of Incorporation number Incorporation c) Is your organization registered as a Charitable Organization witn Revenue Canada? No Yes(Ayes) I Revenue Canada Reg.number 01 pool d) How Zang nas your organization existed? What is the financial year end of your organization Years �' MaI� Month Day 3. Affiliates Is your organization affiliated with any corporation or organization? No' 7 Yes Ayes.•Mist the legal Names(Attach separate sheet if necessary) ey 4. Use of net proceeds What wilillll the advance funds be used for?(Attach separate sheet it necessary) a)Dili CQ 6�NOl f t2 b) C) d) Questions? Call 1-800-387-0098 oLC cae 001(MV05) Con limed on back 5. Lottery trust account Name or financial institution where lottery funds are held Account number , C - 1 • g C . 4 b-c43ii� Address city 2 6. Unorganized Areas Is your Charitable organization located in an unorganized area? 7 No 71 Yes(If yes,please inoicate) ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED J RAINY RIVER UNORGANIZED KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED MANITOULIN UNORGANIZED 71 THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned. declare that: • /we are a Principal Officer of this, rganlzatlo0 , • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. 4 • I/we agree to deposit all advance funding into_the designated lottery trust account, s • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature �1Y r„uK1L KoArreQ Printaame In full �� ,mss �RES�DPI►? Tlue .1� Business telephone number cglolS) b113 aklol7 ( col I lal — Date Signing Providing inaccurate information may render your organization ineligible for advance funding', Questions? Call 1-800-387-0098 Ce formuloire es*cuss;o`isponble en fronpeis. "SOC/AMN OF HI 'aQ ROS'P/TAL VOLUNTEERS — BOWMANVULE August 31, 1998 Garth Manness, President Ontario Lottery Corporation 70 Foster Drive, Suite 800 Sault Ste. Marie ON P6A 6V2 Dear Mr Manness, Our Association has grown to the point where it is necessary to have an office in the hospital in order to give better service. The office will need to have a desk and a computer, etc. to enable us to keep volunteer records; minutes of meetings; newsletter; mailings and monitor daily activities. Attached is a breakdown of what will be required to set up an office. All monies raised by our Association are used to purchase equipment and other items as requested by our hospital - Lakeride Health Bowmanville. See 1997198 Budget attached. We trust our application will meet the guidelines as requested. Sincerely YJune Hunter President 47 Liberty Street South, Bowmanville ON L1 C 2N4 1 ASSOCIATION OF HOSPITAL VOLUNTEERS - DOWMANMIS BREAKDOWN OF ESTIMATED COST OF SETTING UP A VOLUNTEER OFFICE Desk $500.00 Filing Cabinet $500.00 Office Chair x 2 $400.00 Shelving $200.00 Computor $5000.00 Laser Printer $2500.00 Sundries: $500.00 Stapler Hole punch Files Paper tray etc. TOTAL $9600.00 <— 47 Liberty Street South, Bowmanville ON L1 C 2N4 APPLICATION 12 ADVANCE FUNDING CHARITY ROSTER APPLICATION o.nnA r•tAncu•noev. e Foster tmnn Suite Please see attached page of Instructions. 7p faster Ori�p,Suite app Sault Ste-Marie.Ontario P64 6v1 - Please print or type - 1. Previous charitable gaming licence • ' • • Has your organization ever applied for a charitable gaming event licence? QN0 F—]Yes(Ifyes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing [a No ❑Yes privileges suspended in any jundication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name BeAhe Ja Celneler Street address of organization City Province onces5ioh 5 . 0o �� &Ihesda- R � 5" W,047Vil O/I( Postal Code Telephone No. Fax No. Mailing address Indifferent) Postal Code 77L 0/d S( ugog koad Z512/7 4 %/en dN l alb( b) Is your organization incorporated as a non-profit organization? E A ❑Yes(If yes) Jurisdiction of Incorporation number Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? q ❑No E2 Yes(It yes) Revenue Canada Reg.number 1 g I ! 0 1 I �I '01 / 191 S aea d) How long has your organization existed? What is the financial year end of your organization Cemefery has exisi d 1,;26`-ryears Years Cemdery board has existed 3 f o clears / Month I gay � 3. Affiliates LJ V organization affiliated with any corporation or organization? ❑Yes It yes: List the legal Names(Attach separate sheet if necessary) a) b) 4. Use of net proceeds a CDC What will the advance funds be used for?(Attach separate sheet if necessary) a) re,P(iir Jal)c,e17f hwys�o�es b) r I // a cae C) M46174eAdtice of grou_ deFel d, & lj s�r�ge s�ie� Ar /oo, Questions? Call 1-800-387-009B OLC CAP 001(98105) Continued on book 5. Lottery trust account Name of financial institution where lottery funds are held Account number , Canacm ,*7 I5`- O1,21 ! Address city b1, //e 6. Unorganized Areas Q 7 V C Y �NoIs yo Charitable organization located in an unorganized area? 7]Yes(Ifyes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED F� RAINY RIVER UNORGANIZED KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • Uwe are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • Vwe agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer inci al Offi r Signature ` Print name in toll S 1 .Secgqre->< r�%reQSGlr2� T1111le { I c l 5 6131 — I,�i 91 1 Business telephone number a /O Date Signing ,{ 9Y-- Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloue est oussi disponible en frongois Bethesda Cemetery Board c/o Lynne Piggott 7762 Old Scugog Road Enniskillen Ontario , LOB IJO Marie Knight 40 Temperance Street Bowmanville Ontario , LIC 3A6 '--pnvPmber 24 . 1998 Dear Marie am applying for an Ontario Lottery Corporation grant to help fund sp-irp-r.- I - :e- °- L the cemetery , 1 ) There are many ancient stones at the Cemetery which are in need of being repaired/replaced . The board has recently repaired four stones at the cost of $2442 . 00 . 2) We urgently need a reliable source of water e . g , a drilled well . it is embarrassing for the board not to have an adequate supply for the public to use as well as the hindrance imposed on the caretakers in the performance of their duties . We are left with no option but to continuously purchase water as there is rarely enough precipitation to even partially fill the cistern . 3 ) The chapel could use some repairs/ improvements , etc , such as new interior lighting , sentry lighting for the parking/chapel area, more seating , roof , doors , etc . The grass/gardens and bushes/shrubs are endlessly in need of upkeep/replacement . 4) A new shed in which to store tools , burial mats , etc . is required to replace the one that was demolished by a wind storm. The services provided by the cemetery are : the sale of plots , opening and closing the grave , monument bases , cornerstones , and the maintenance of the grounds and chapel . Enclosed , you will find a copy of the service prices . The chapel provides storage of the deceased for the winter months and a place in which to hold services and/or board meetings . There are eight board members who hold voting rights at the board meetings . Enclosed , you will find a copy of the member ' s names . Each member has a specific duty to deliver a particular service to clients . The board does not have an assigned operating budget . The funds that have accrued during the previous year ( from the sale of plots , cornerstones , monument bases , and donations , plus matured investments if needed for a special project ) minus expenses are those which the board uses to operate . Bethesda Cemetery - 2 - The caretakers and board members do their very best to keep the cemetery in excellent condition. The grounds and chapel are kept ept in good repair . The safety of those visiting the cemetery is an utmost priority . Due to the efforts of these dedicated people who take care of the cemetery , it is a location in the municipality that is pleasant to behold and visit . Primarily , because the board does exist , the municipality is not burdened with the task of dealing with yet one more responsibility . Therefore , a grant , to be used only for the perpetuation of the cemetery , would be greatly appreciated . As of the writing of this letter , we have four investments , one maturing in December , two maturing in 1999 , and one naturing in 2000 . The approximate total worth of these is $53 000 . 00 not including interest . These are usually re- invested , unless as was stated earlier , there is a special Project planned . Once a year , the Public Trustee .sends the board a cheque for the accrued interest on the money that is locked into the Perpetual Care Fund which usually amounts to between $900 . 00 and $1100 . 00 depending on the prevailing interest rates . I hope you will look favourably upon this application and allot a grant to aid in the continuation of the cemetery . Also , please find enclosed the application form, a copy of the bylaws , a copy of the letter from Revenue Canada regarding the registered charity number , and the original bank account statements for 1997 . Yours truly Lynne Piggott (Mrs . ) Secretary/Treasurer Bethesda Cemetery Board Enclosures APPLICATION #3 CHARITY RoSTER APPLICATION ADVANCE FUNDING,' aanstaorr cdw.a.. 0Foler r"`b111101O Please see attached page of Instructions. 70 Fas(er Ori�e,Suite aoo p 9 Sault Ste.Marie Ontario aeASVZ - Please print or type - 1. Previous charitable gaming licence • • • • Has your organization ever applied for a charitable gaming event licence? ®No 7 Yes (if yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? FR No Yes 2. Information an organization GIN a) Incorporated or legal name Street address of organization City Provinc 14 1 Lt her We f+ _ VA Rb,43 Postal Code Telephone No. Fax No. L I C Z P Z (9r o5 )6 o 5 (o i7_ _ 60 Mailingadaddress(ifoillemrittt) Postal Code SEX Ll 3k � b) Is your organization incorporated as a non-profit organization? ❑No ®Yes(If yes) `qS�q�, OI Juds�ction of Q6 for,Incorporation numbe -�`S Inco oration (,-,) o c) is your organization registered as a Charitable Organization with Revenue Canada? (Yid (ee.Q/st-r C9(-\ No [Z Yes(if yes) Revenue Canada Reg.number 0 19 I()IC 11 I j5 5I—I I7 I^ I p d) How long has your organization existed? What is the financial year end of your organization Years 03 31 3. Affiliates SJ OOC7 Is your organization affiliated with any corporation or organization? ®No Yes f!yes: List the legal Names(Attach separate sheet it necessary) a) bl 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet itnecessary) `r !i )rpSPFA(11q if iVIelyY'at ) t -`�c10vJi�sztfd79j a) \A1�rr 0 � C` � � n b) an5 j 5LAY-eo hT1 c) I C S { ��� lt�L�f KQr� d) rt-C)C n to am e 1 Questions? Call 1-800-387-0098 OLC CAP 001 (98105) Conhnued on boc S. Lottery trust account Name of financial Institution where lottery funds are held Account number Avo W�6r-s clmm, Address Sfi. E. `"yF� c ���le, 6. Unorganized Areas ov Is your Charitable organization located in an unorganized area? ®No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal O}ffic�er Principal Officer kele� ��Wd 'w"I name In full �a;r , �� & bkrec� a : ExeG��i�f' Lrec, 1 PIS) 101 2-31 — I� 4Is "eel telephone number 9113 612-131 — I( N 141 `J W �� eOak Signing Providing inaccurate information may render your organization Ineligible for advance funding Duestions7 Call 1-800-387-0098 Ce formuloire est oussi disponale en franpais APPLICATION ►4 ROSTER CHARITY APPLICATION NWO Loom Ca ro..N, 70 0 FM M+raIMn N11NrOr10 Foster Orive,Suite 800 Please see attached page of instructions. Sault Ste.Marie.Ontario vensvz — Please print or type — 1. Previous charitable gaming licence • ' • • Has your organization ever applied for a charitable gaming event licence? No t/fYes(if yes) .Nc� )'rvi - 1 'ti�e (YE/✓77CKE , What is the most recent licence number issued by: AGCO: P Municipality: Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? ONO Yes 2. Information on organization GIN a) Incorporated or legal name vTHFK s C F C LA-A"l/V C! /'V Street address of organization City Province 3 5C' (fiC ��; Tr'EE ' ; 'CCJ/,7r7jvL/, LCC o Postal Code Telephone No. Fax No. 4 1 W t, 5)6 1,2131 �ZL S ) �' � 3 Mailing address(if different) Postal Code b) Is your organization incorporated as a non-profit organization? 7]No 2Yes(If yes) Jurisdiction of L� Incorporation number Incorporation Y�L'4irV� C c) Is your organization registered as a Charitable Organization with Revenue Canada? // / / No Yes(U yes) Revenue Canada Reg.number I I �%I 71 �f d) How long has your organization existed? What is the financial year end of your organization Month Day / Years � � ( ti��-C ���`!:3t� 3. Affiliates Is your organization affiliated with any corporation or organization? 4)mz) f/LIT W 4)OF 5rE :9j6_ 7 No [g Yes If yes: List the legal Names(Attach separate sheet if necessary) arCr 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet if necessary) _ rY'%%C /'�I 1� d L �/Ij-9 a) dW F 7L� & /,_'All)/7/�✓��kt�/LJ b) c N -x %�Z L'C /`��iti ;lii//� r(� d) 1�(/751"' .'( ! 1-7-11'111 Questions? Call 1-800-387-0098 oLc CAP 001 fearosf Continued on back Lottery trust account + Name of financial institution where lottery funds are held Account number JO Address Ciry _ 6. Unorganized Areas Is your Charitable organization located in an unorganized area? gNo ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only • 4`..^••'�� y *able_game.events at the-local-charity casino: J�C • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer 1 � ' MN s,-i.i i� bIPr r An/4 00�S i Print name in full /8CH5cr K E� Title PRESi 'd Business telephone number C 9, 0 ,5 ) JIR171 — II � II -� ° Y Gate signing ' Providing inaccurate information may render your organization ineligible for adval4c/�e funding Ouestions? Call 1-800-3B7-0098 Ce formulare esf aussi disponible en frangois. BIG BROTHERS OF CLARINGTON It 23 Scugog Street, Bowmanville, Ontario L1 C 3H7 Tel:905-623-6646 Fax:905-623-0704 November 26, 1998 Municipality of Clarington 40 Temperance St. Bowmanville, ON L1C 3A6 Re: Advance Funding Application Big Brothers of Claringon was established 21 years ago to provide for boys the stabilizing and helpful influence, guidance and friendship of mature, interested and responsible men who could set a good example which boys could follow. Throughout the years Big Brothers of Clarington has expanded its services to further meet the needs of the children of our community. See Section C on Services. While expanding our services we have maintained a small staff; but, in order to continue to grow to meets the needs of our growing community we must have more hours for the current staff. A Recruitment Officer would be beneficial to recruit potential volunteers to serve as Big Brothers, Mentors, Big Bunch Buddies, Board or Committee Members.. Funding for the services provided by Big Brothers of Clarington is raised directly from the Clarington Community. As we do not receive ongoing government funding or large corporate donations it is imperative that we have the opportunity to access the funds available from Advance Funding. We feel it is important that these funds stay within the community. Currently our financial situation is very good. Through hard work and the support of the community we have been able to secure the funds needed to provide our services to the children of the community. However, as we are dependent on the community for our sole survival our financial situation can change drastically from year to year. In July 1995, we lost our Nevada location and the agency was without these funds for IS months and it was only because we had a contingency fund that we were able to make it through 1996. Last year we were facing a huge deficit in funds but through cost cutting efforts (such as accepting no new Little Brothers and working with only two part time staff) and fundraising we were able to survive. Big Brothers of Clarington is asking for $95000 to increase staff hours, upgrade office equipment and for recruitment materials. (See Section C page 5 for a breakdown). These funds will allow us Share the Fun-BE A BIG BROTHER A United Way Agency S to expand our service delivery, fundraising and recruitment to meet the needs of our rapidly growing community. The programs provided by Big Brothers of Clarington are very beneficial to the community since they are preventative and will have long term ramifications to benefit the future of the children of the Clarington Community. "Our main goal is to aid in the healthy development of children at risk through the auspices of a caring adult role model." (Big Brothers and Sisters of Canada President, Ruth Kelly). Our programs have the ability to produce a healthier community and with the growing population in the Municipality of Clarington the need for our programs will only increase. A supportive neighbourhood can do wonders for a child even"one caring adult can turn a child's fife around." (Ontario Health Study 1994) Thank you for considering our application. Big Brothers of Clarington look forward to hearing from you soon. Sincerely Nancy Scott' Executive Director APPLICATION #S -1111 Fill VM, ° le800 ° Please see attached page of instructions. /0 Fosler Drina.Suite Bdd Sa,n Sre.Maria onariD rcn evz _ please print or type — 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No ©Yes(Nyes) What is the most recent licence number issued by: AGCO: P Municipality: M SD RIO(, Have you had gaming event licences cancelled or licensing ®•No F1 Yes privileges suspended in any juridication in the last tuo(2)years? 2. Information on organization =GIN a) Incorporated or legal name Street address of organization 3 City Province �. Postal Code Telephone No. �/ fa[NO. 1 �� LIB 11%� y I-�1 ( 91o�) 761,61 I �/ � 161 � t �,o•s) S;�I q, IA v1. T1� Mailing address(itdrererf) Postal Code b) Is your organization incorporated as a non-profit organiWion? No ®Yes(11yes') lunsdiciion of Incorporation number b,fd V3 Incorporation c) Is your organization registered as a Charitable Oroanization wth Rwenue Canada? XNo Yes(It yes) Revenue Canada Reg number I d) Hoar long bas your organization existed? What is the financial y"cr end of your organization �� Month Day Years /G✓r✓:7 — /"/�ri I ///A`� I J 3. Affiliates Is your oreanization affiliated With any corporation or organization? E]No ©Yeslfyes: List(he legal Names. (Ay?:h Separate s::'leelilnecessery) a) /'� IlVe-Z4 Y /,/C - b) 4. Use of net proceeds r What will the advance funds be used for?(Allll�achs�2rae shed ifnecessary) al PAS car lel;.;-,4L, .ACt 0C4 b) C) d) avestions? C-111-600-387-0098 ConfinuE:on boc% r.c as ooi rraasl 5. Lottery trust account .. 1 Name of financial institution where latteryfundeare held A=unt number t Cif G a ,d ii /t; c.✓H/7 . Address city 6. Unorganized Areas Is your Charitable organization located in an unorganized area? No ❑Yes(1 1yes,pleaseindicale) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We.the undersigned• declare that: • I/we are a Principal Officer of this organization. 1/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • Vwe agree to deposit all advance funding into me designated lottery trust account. Itwe agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application.as well as all the information contained in the documents and materials submitted with it are true and complete. - - / We have read and understand the entire Declaration above. Prin6 at Oft! Principal Officer Print name to full f �IkJS-/A)C _lq _ Title `L i Business telephone number- 7 / ( �,1, /0l� ) SI ,)1 �1 Busi — 161LI �1S - _. ( Iyt �`5-t `/ Igo = llct�t / I� /// Q tJ -2 6 / >�-� <....Dale Signing. �C/2_ Providing inaccurate information may render your organization ineligible for advarCe funding Questions? Call 1-800-3S7-0098 Ce lormut62 a;:cussi di;pOni57e txt frcnpoa. APPLICATION 16 a.uno ronen ca.pwnio. some er.ra�.n.=e.roa>n° please see attached py 'r��"ructions. iOFasler Oriw,sude bi0 ff�-(� 'i 24 AM �QQ Smd she.mane.oran9 - please prin or ype rea evz OR 1. Previous charitable gaming licence F OFFICE USE ONLY: Has your organlzatl ever applied for a charitable gaming event licence? No [Yes (Ryes) What is the most recent liccca number issued by: AGCO: P Wtunicipality:M ®69 Have you had naming event licences cancelled or licensing No r j Yes privileges suspended in any juridication in the last two) (2)years? 2. Information on organization GIN a) Incorporated or legal name Ck (D COISC - T Q n!� G,; Province Street address of organization o . 9 o C 37 0RoAl0 ont J Posel Code Telephone No. — E�rDE�1T axr:p. ESf1�6NT �JoB1 ( i 16 913 1s1 _ 1�Is�,6 ry�/16 ) �l� l� — I �IVI�I � I Postal Code Mailing address(ildiRererel b) Is your organization incorporated as a non-prom organization? 5T, E]Yes Jurisdiction of Incorporation number Incorporation c) Is your orgarJ_tion reo'st_red as a Charitable Organization wish Revenue Canara? CNo E (. es (llyes) fl nueCanoCla ^ tl) Hcc:long has your organization existed? - ,_-.Cal year end of your organization Month Day Years 3. Affiliates Is your organization affiliated with any corporation or organization? . .lo Yes fl yes: List the legal Names(Attach sef2aah sheet it recess::,' a) b) 4. Use of net proceeds K I i coo What will the advance funds be used for?(4!tach separate sheet ilnecessary) b) rCke—USS10 � Q � r 1 p q uN y/oKnt S o)�r1 �1 Lac cA Pcnl/i T orJ d) 64's Qaesfions? Cali 1-800-387-0098 Continued on boci OLC GAP 001(90/05) 5. Lottery trust account - Name of financial institution where lottery funds are held Account number ' Address Oil 9 TC,rI i s A/jc C S i L�� r•!�✓IRnJ f/�6 4_ � o n1 6. Unorganized Areas PtIs y ur Charitable organization located in an unorganized area? No []Yes (It yes,please indicate) ❑ ALGOMA UNORGANIZED F� PARRY SOUND UNORGANIZED ❑ COCHRAN' UNORGANIZED [] RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED F-1 SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned, declare that, • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes cniy. • IAve will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration. above. Principal Officer Principal Officer 1 Signature �- 1 i Print name in full PRES ,6r_tJ Title SE Er,/Zy b Business telephone number ( l l6 > 8131 S - I�So16 1-31-yj S l l 17 Date Signing,- Providing inaccurate information may render your organization ineligible for advance funding r Questions? Call 1-800-387-0098 Ceio(mulor28>,cuss)disponibleenircngcis. CLARiNGTON CONVERT SAND T he following is an itemized list of where the band intends to use the advance funding (if awarded such) monies: Incorporation $2,000.00 Percussion eccesories $5.000.00 Music purchase $5,000.00 Band Uniforms $5.000.00 TOTAL $1T000.00 APPLICATION /7 o.un.lone.r tarywnrw soweue..rw.nn a.r'o.r.n° Please see attached pags „` instructions. 70 Fo5rer Dr,..noire Boo S,+r Ste.Made.Dmz"o - please print or type - .. P6A 61/2 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? Al No L]Yes(if yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No Yes privileges suspended in any Indication in the last two (2)years? 2. Information on organization I GIN a) Incorporated or legal name C4PR1A16'7_1)ZV_ C, /P-) 5 �-/0(KE X Street address of organization C1, P�ro�viinnccee �' - 4 // Postal Cote C /Telephone No. Pax f:C hl / Ifu IMI ,J 1911 �) J 12 13,1 — 1191 (9 — 161/:I Mailing address(,t duezent) I Postal Code i I I I I b) Is your organization incorporated as a non-profit organization? ®No C Yes(L`yes) l Jurisdiction of Incorpera;icn-,umber Incorporation C) Is your crran!zzlion registered as 3 Charitable organization with Revenue Caradat No Yes(NyBS) Revenue Canal.,Reg ni� I I I I I I I d) Horr!cn^'as your organization existed? v: s:-.el.ranual yEar end c!your organization z— Month Day Years--- 'ri vE (6) I M 3y 121 3. Affiliates 0c,0 - Is your or_nization affiliated with any corporation or organization? 11 No ©Yes it yes List the legal Names(Attach,s{eparatesheaf d nzcess_-.! a) CSHAv A (' IR S�1�cYKE`I '1LCZrri ror�) 4. Use of net proceeds YJha;wil!t:?e advance funds be used lot?(Attach separate sheet it necessary) a), nrrR'nJEI/J'l.E/�t7 b) TR/i//Vly4 d) RU/VA//A/ 6 ILA r,I/E Oueslions? ;zll 1-600-387-0098 Continued on bock OrC GP 001 @m05) I S. Lottery trust account Name of financial institution where lottery funds are held I Account number Address City 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No ❑Yes (if yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENORA UNORGANIZED SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that • I/we are a Principal Officer of this organization. - • 11we are NOT receiving remuneration directly or indirectly from the advance fundine. • 1/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • l/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted%-Ath it are true and complete. _ We have read and understand the entire Declaration above. Principal Officer Princi al Officer Signature _ G � Print name in full El/L-F c y 1_eJ46 O nI �Ek� rO�DR hl Title Q6A;% Business telephone number ,/ � � lU1S ) Gj1�1 I 61912 ., �q &I15) `fDl `-fl - lot flfpl '� 97 Date Signing._r; wOf/°mriFi �_2 / 9�� (Providing inaccurate information may rende'your organization ineligible for advance funding Oueslions? Call 1-800-587-0098 Ce rormv!c::P es;ecssi drponiole en frongois. 85)Pueen Street BQWMANVILLE, Ontario LIC IM5 905-623-1592 L RTNGTON November 26, 1998 L GirCs Hockey Town of Clarington Association 40 Temperance Street BQWMANVILLE, Ontario HAND DELIVERED Dear Sirs: 0 e Re: Charity Roster Application - Advance Funding Ontario Lottery Corporation Enclosed herewith please find the following: ti 1. Copy of Clarington Girls Hockey Association Constitution and By Laws m 2. Letter detailing the outline of programs/services 3. Operating budgets for 1998/99 and 1997/98 4. Financial Statements for 1997/98 5. List of Board Directors 6. Application reguesting the amount of$10,000.00 Trusting this is satisfa story and we look forward to hearing from you at your earliest possible convenience. Yours truly, Beverly Encl. - 6 / 3 L�,I5GTON Gitfs Hockey Association DETAIL OUTLINE OF PROGRAMS/SERVICES The programs and services offered is organized hockey for females between the age of 6 to 18 years of age. This allows the girls to develop their leadership skills, as well as athletically, with their peers. At present we have an interlock agreement with the Oshawa Girls Hockey for house league. This allows the girls to play a variety of teams within Clarington & Oshawa in their own age level. Clarington Girls Hockey is attempting to run their first annual Spring tournament this March, which will be an Association tournament. This is to be held at the Garnet B. Rickard Complex. We are planning on having the girls involved in every aspect, allowing them to obtain knowledge in how to organize and run this event. With all the media exposure about abuse in sports it is our intention to have every volunteer obtain a police check and attend a clinic pertaining to the above, which will be done through our local Red Cross. This is to provide the girls with a save environment in which to learn the skills of hockey and have fun. Clarington Girls Hockey is planning on expanding to the competitive level of hockey, as the growth requires. At the present girls from our area are venturing to Toronto or Pickering to get this exposure. We would like to build our organization in order to have our girls given the same opportunities as minor hockey in our area provides. In order to do this we must have the ice and the money to pay for this. We look forward to your help in forming a bright future for the girls in the Clarington. APPLICATION #8 R�l//l�IORM r0•x«Im� rMlNh�INMU4P0�1/M please see attached page of instructions. Jd Foslcr nnn.Sut:B00 sM Sic,aaee.omr,d° AM 6p7 _ please print or type - 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No Oyes(1(yes) o What is the most recent licence number issued by: v AGCO: P— N Municipality: N M- 5 Have you had gaming event licences cancelled or licensing IANo nYes '-'- privileges suspended in any juridicalion in the last two(2)years? ca 2. Information on organization GIN a) Incorporated or legal name CLARIMGTOK MINOR dogike ASSOCIATicM C jp,115 1 1 4 5 Street address of organization city Province -PO, BOX Sal IBOkIMANVILI� ant;ARib Postal Code Telephone No. Fax No. /_ �7 L , I IC13f K1q f IC tS )� 1� f31 1718121 (� 1� 1� �2W1�1 - 1�18�1aj5 Postal Coda Mailing address(if dilfererl) SAME. b) Is vour organizlion incorporated as a non-profit organin:ion? E]No Yes(Il yes) Jurisdiction of In[orponlion cumber 429488 Incorporation �NTH�tO c) Is your organi .tian registered as a Charitable Organization wish Revenue Canada? 4j No Ej Yes (1f)-S) I Revenue Canada Reg number l d) Ho:,long has your organization existed? What is the financial year end of your organizati3n Le-TTLK Fwmt fT 197q Month Day Years 27 Slt`ICE 1971 I OS I -J31 3. Affiliates Is your oreanization allilialed with any corporation or organization? E]No dyes 111-s: list the legal Names(AYcJh svaral!sheal if necessry) Z) ONTARIO MIMOR HOCKEY AZSUC1ATfCA1 b) CANADINN 6MATE�((�IR OQCKe ASS C100 4. Use of net proceeds $ r C)CDO • �� What will the advance funds be used for?(Allach sNraraleshed ifnecessary) a) F IC�f REDUE IC)M e) EQUIPMa iT"- Svjej)TeRS SOCKSI REPAI r) Tc�E TKIE �ENI RL�EXPC-NSE d> ADKIINISTf�ATC�I( " OFFIC'E��PLIE Ouesfions? CjI1-600-387-0098 Confinuec On boC� 5. Lottery trust account ._, r.. _ Name of Rnanelal Instllutltin"em lottery fundiare held II Account number Address city L�r 1��� u Yv�vw 11 I 6. Unorganized Areas Is your Charilable organization located in an unorganized area? sy I�No Yes (Nyes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED C] KENDRA UNORGANIZED F] SUDBURY UNORGANIZED MANITOULIN UNORGANIZED F1 THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: Uwe are a Principal Officer of this organization. Itwe are NOT receivino remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behall of the organization. �L • Itwe agree to deposit all advance funding into the designated lottery trust account. • Ihve agree to use the advance funding for approved charitable purposes only. All answers provided in this Application,as well as all the information contained in the documents and materials submitted with i; are true and complete. We have read and understand the entire Declaration above. _ 2//,n/'s Priinc-iioopll,Officer - Principal Officer Signature /��' - l v PAUL_ R. �AcKmHN ` Print namein full _ lem��l It le 2C�1 (2C C.M.N.A. PRESrI r fT -` C .m H -f4 . Business telephone numher: � ) / �3 — 3 � O ID15 ) (pI213I - I91 1 I ; (°� 1�1 L 11 1 t .�..,:... 'Date Signing:`°.'J.;i :4&V of _ 998 Il�oJ . 1 t 1�1? Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-3i:-0098 Ce forrrxfci2 9i cusst 0;ponip:e en frUnQ06. CLARINGTON PO, BOX 191 � ) MINOR HOCKEY ASSOCIATION BOWMANVILLE ONTARIO- CANADA (formerly Bowmanvilie Minor Hockey ASSOC]Mon) L IC 3K9 BOWMANVILLE Municipality of Clarington Attention: Marie P. Knight Deputy Clerk Ms. Knight, please accept our application and supporting documentation as our request for financial assistance as per the current Ontario Lottery Corporation, Advance Funding Program. On behalf of the Clarington Minor Hockey Association, Paul Jackman the President, and myself(Mickey Cryderman -Treasurer) request consideration to have our organizations' name included in the roster of applications to be reviewed by the General Purpose and Administration Committee on January 18, 1999. To the best of our ability,we have included all supporting documents as requested. If you have any questions please feel free to contact myself or Paul at the numbers listed below. Thank-you for your consideration, Mickey Cryderman Pau ackman Treasurer- C.M.H.A. President- C.M.H.A. (905)623-6360 (905)623-9538 C.M.H.A. OFFICE PHONE/FAX(Oct. 1,st-April 1st) (905)263-7825 November 27, 1998 DEC I 315 PM '98 Charity Casino- Advance Funding Review Team: This letter portion of our application for the advance funding is to notify you of the amount of dollars the Clarington Minor Hockey Association is requesting. Our association is grateful for any amounts of money with regards to grants or donations from any and all sources. In complying with your request to include an amount requested with our application, I would ask to first explain our current and projected financial status. During the past 3 seasons a number of issues have put a huge financial burden on our program. The first being our associations name change from Bowmanville Minor Hockey Association to the current Clarington Minor Hockey Association. This was done to better reflect and represent the name of our Municipality and the tatal area from which we select our players. This meant the need to change 34 full sets of sweaters, designing of a new logo, letterhead, envelopes etc. as well as the legal costs for the incorporation name change. This had an approximate $30,000.00 dollar impact on our association. During the past 2 seasons with the overwhelming growth of our area, we found a need to expand our program to accommodate the large number of players with the skill levels to play representative hockey. In order to accomplish this our association had to travel outside the Municipality to secure enough ice time to ice our teams. We traveled to Scarborough, Pickering, Whitby, and Oshawa arenas in order to maintain the quality level of our program. As you are probably aware, ice time costs for outside of community residents is at a premium, and we paid in most of those outside arenas 2 1/2 times the fee for 1 hour of ice as opposed to ice fees here in Clarington. In order to secure ice time at The Ice Palace in Oshawa lasts season, our association had to pay in advance $55,000.00 dollars. Enough said about ice time. The final issue is our association has been granted "AAA" status for next season(1999 - 2000). This is the highest level or"elite" level of hockey offered to players at the minor level. This is in part a reflection on the quality program Claringtons volunteers have been organizing and operating for many years. It also places Clarington as a community into a league with the large elite centers and will undoubtedly have a positive impact on this area in the future. Having said that, there will be a need to purchase some new sweaters again to start replacing sets that are becoming worn. There may need to be a change of our hockey pants and helmet colours (due to manufacturer availability of our current red colours). At this time our estimate for replacing used sweater sets next season is $10,000.00. , In closing, we have included with our application, an audit from Laing McHardy&Rohr, Chartered Accountants, which reflect the current debt load of our association at $20,400.00. In an effort to improve the Clarington Minor Hockey Association to the elite level and have it remain affordable to all the youth of our community, we are humbly requesting advance funding in the amount of$50,000.00. If you require additional information or have any questions, please contact either myself or Mickey Cryderman, our Treasurer. Sincerely, Paul Jackman Mickey Cryderman (905) 623-9538 (905)623-6360 Review Committee: The Clarington Minor Hockey Association promotes,encourages, and governs organized hockey for boys and girls eligible to compete in OMHA hockey representing Clarington, under the governing body of the Canadian Amateur Hockey Association. Our hockey program is comprised of 16 teams from Minor Novice age to Juvenile age(ages 7 - 20). This level of competition involves playing other towns and centers and is referred to as "representative" hockey. The program involves practices, goalie clinics,classroom instruction,tournaments and games. Our main reason for applying for these funds is that our organization began our 1998 - 99 fiscal year in a $20,000 deficit. There are many reasons why this debt has occurred. Three years ago,we changed our organizational name from the "Bowmanville Minor Hockey Association" to the"Clarington Minor Hockey Association". This name change was done to reflect the new name change of our Municipality of Clarington. However,we incurred a large equipment and administrative cost to reflect this change. Also, in order to provide the level of hockey we do offer, our organization was forced to go outside of our Municipality last year to acquire enough ice time to house our 16 teams, as the ice offered in Clarington was not sufficient. This ice was secured in Oshawa but the cost per hour was almost double our rate in Bowmanville. These actions have left our organization heavily burdened in debt. Our association organizes and operates 4 tournaments per season. We host teams from Ontario, Quebec,and the United States. These tournaments are run over a weekend, therefore, our community of local restaurants, hotels, and businesses acquire these economic benefits. Our Executive is diligently working this year to alleviate this debt and be creative in our fundraising attempts so as not to drive the cost of a child playing hockey so high that it would be unaffordable to many families. We thank-you for your consideration and we will appreciate any amount of money to help alleviate our current deficit. Yours sincerely, l ckeey ( ryZrman P ul J an Treasurer President Clarington Minor Hockey Association Clarington Minor Hockey Association APPLICATION #9 TIMI Ill JM 0�1!/I°r°IIe+y C°rywJll°i S°dll#1.,l°Im"°.ID°bE° Please see attached page c :nstructions. 70 fosler oniv,Suite 800 P6ASlez+Iade.orario - please print or type - P6ASV7 1. Previous charitable gaming licence Has your organization ever applied for a chat itable gaming event licence? No JyYes(It yes) i What is the most recent licence number issued by: AGCO: P Municipality:M 0 6,A$� Have you had gaming event licences cancelled or licensing No Yes suspended in any juridication in the last two(2)years? r� 2. Information on organization GIN a) Incorporated or legal name J 1 CL (�-�It� I p� OLl7L � � t�. IJLI 1�"S517C1 A'1� o I Street address of organization City Province � (0 '9C v wMfNiti, Postal Code ^� Telephone No. / p q �7 �✓- J Fax No, LI I IC 31 A-I `Z ( r LI'') V1 9171 _ 12, bf J; L 1'.9 LIS)GI 11j1 — 1716 1 ,5—icl) 6lailing address Hddterenll i Postai Code b) Is your organization incorporated as a non-prola organization? ❑No Yes r;°�ESJ _ Jurisdiction of i 2�J Incorporation number .127�7r-f'-�j I Incorperztion n c) Is your organization registered as a Charitable Crganization wah Revenue Caezda? O D I No gf Yes (llyes) Revenue Cana^_a Reg.ncm;e- of Ho••u Fong has your organization existed? year end of your organization /n lM7onth Day Years I NR'"-L' 1} 3 3. Affiliates Is your organization affiliated with any corporation or organization? KNo IJ Yes I(yes L isl(he legal'lyres(Attach z9araL shell i!rsessa:y! a) bl � 4. Use of net proceeds �, (--C What will the advance funds be used for?;;:'aca sepaa'esheel ifrecssrry) a) /%r/-enter f P e �.i7`rl'cic�-i..� �'�f�eJr,Jo)• C) d) Questions? Call 1-600-387-0098 Continued on boc OLC CAP poi(W05) 5. Lottery trust account .. Name of financial institution where lottery funds are held Account number Address city 6. Unorganized Areas Is your Charitable organization located in an unorganized area? No ❑Yes(fl yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENORA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • Ihve are a Principal Officer of this organization. • 1pwe are NOT receiving remuneration directly or indirectly from the advance funding. • Ilwe have been authorized to make this application on beha!f of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • Ilwe agree to use the advance funding for approved charitable purposes only. • lAve will sponsor'able game events at the!ocal charity casino. • All answers provided in this Application. as well as all the information contained in the documents and materials submitted with it are true and complete- We have read and understand the entire Declaration above. Princi al Officer Princi al Officer t / - i Signature r Print name in full hit/rJ 1�o tiyA c n Gt r F_ L 5'f/ - �r�/ Title E� E4�= _ r V I I l�l — I�I �1 J I Business number.c r q 101 Date signing.---,. ` l Providing inaccurate information may render your'organization ineligible for advance funding Questions? Call I-808-387-0098 Ce iormucr°est cuss)Gh;ponible en r onc;ois CLARINGTON OLDER ADULT ASSOCIATION Charity Roster Application -- Advance Funding ( a ) Computer Work Stations—(2) $4000.00 (To be set-up for Older Adults) (b) Software & Internet Connection $2500.00 (c) Additional Computer Work Station $4000.00 (For General Office) (d) Year 2000 Compliance $2500.00 (e) Elevator $40000.00 (I) Operations $27500.00 TOTAL REQUEST FOR ADVANCED FUNDING $80,500.00 REQUESTS FOR ADVANCE FUNDING It is our understanding that the advanced funding is for one-time g,rants; therefore , The Older Adults Association is requesting that consideration be given to assist them with providing the membership with the programs and facilities they need. The Executive want to make the Clarington Beech Centre a place where all the older adults in Clarington can use and meet their expectations. USE OF ADVANCED FUNDS (a) Computer Work Stations-2- Over the past few years computers have become a way of life for almost everyone from r children to seniors. Debit cards, bank machines and word processors are everywhere and most of the older adults have had to adjust to them. Some of the older adults have expressed an interest in computers and would like to learn more about them and have access to one. If a computer was available some of the older adults would make use of it for word processing and spreadsheet applications. (b) Software and Internet Connection If the Advance Funding is approved for any of the computer equipment, we will have to purchase software for these computers. User friendly software will be installed that will allow the user to do word processing and spreadsheets. These computers will also have the capability to connect to the Internet. (c) Additional Computer Work Station (for General Office) At the present time, the staff and the volunteers are using an older model computer that is very slow and too small to run some of the new software programs that would be beneficial to the overall operation. With a growing membership, more activities and scheduling of events the need is more and more evident a new computer is needed. A new computer would improve the efficiency of the office and optimum use of volunteers and staff. (d) Year 2000 Compliance The present computer in the Older Adult Office is several generations behind current technology and it will have to be upgraded before the year 2000. (e) Elevator The Clarington Beech Centre home of The Older Adult Association has three floors_ At the present time all the activities for its members have to be on the main floor_ When the basement renovations are complete we plan to have activities on that level as well and an elevator will be required by some of th e older adults to have access. (f) Operations This component of the application is broken down into three sections. The breakdown is as follows. 1. Photo Copier $2500.00 2. New Carpet and Sub-Floor Repairs 55000.00 3. Folding Wall $20000.00 (1) Photo-Copier At the current time the Older Adult Association is purchasing this service from Community Care. Copies are being made on a dailv basis and to improve efficiency and cost a Photo-Copier would prove very beneficial. (2) Carpet and Sub-Floor Repairs To maximize the use of the facility and increase the number of programs for the Older Adults the basement has to be renovated. A new carpet and repairs to the sub-floor will finish this room and entrance so it can be utilized and the older adults can enjoy two or three more activities. (3) Folding Wall When this facility was constructed it was designed to allow for a folding wall to be installed in the Large Activity Room. If this portable wall was installed the Older Adults would gain an additional room to hold an activity and it could be rented on some occasions that would generate more revenue and help offset the operating cost of the building. APPLICATION #10 O.UrU1Mery Ca//uN/� fNNNIn IMM�r/rl'0/rM� Please see attached page of instructions. 70 F051er olow,,$vie 800 $lull sit.Made.On;ada - Please print or type !'6A 6'/Z 1. Previous charitable gaming licence FOR OFFICE USE ONLY: Has your organization ever applied for a charitable gaming event licence? No ❑Yes (11yes) aU5t /VeI-G\Ote, What is the most recent licence number .ue y: AGCO: P Municipality: M Have you had gaming event licences cancelled or licefairl9 No Yes privileges suspended in any juddicalion in the last two(2)years? 2. Information on organization TGIN a) Incorporated or legal name 0i /}/�VJ6-lTJ7J Sw;rn C -L)6 'VC Street address of organization Province✓%LL= CA) /. Postal Code (r (Telephone No. 1� /� Fax No. 71 of �) IG1 -IJ 71 131 112, I0 ,0-,S b:ziing address f I Postal Code I t b) Is your organization incorporated as a non-profit organialittn? Ej No ER Yes fNyes) Jurisdiction of a �1 Inorporaroi number I ircerpoatian �lt)T/4R 10 C-$,)40 c) Is your organiz.tian registered as a Charitable Organiationnvh Revenue Canada? K,II No E]Yes(11 yes) I Revenue Canada Rxg numD�r I I I I I I I 1 I _ d) Hoar long tas your organization existed? What is the financial y1r end of your organization Month I oDay Years xec 3. Affiliates 5s you oreanization affiliated with any corporation or organization? Jo �Yes1,,1yes: Lisl the legal Narnes(A?.lr separate Steel itnecessary) a) SWirh Qn 11 r,,-10 b) 4. Use of net proceeds What will the advance lunds be used for?(Allarh sparale shed itnecessary) z1 poy/ RenJi,, b) � —rni'-d (ms'fs C) .G�1� t'X�O Gn c�S d) OCIFT Ce— Exf,S.c S Questions? Ca7t 1-800-387-0098 Con ftnuec On boc, c.c c:r wi r:'vi5 S. Lottery trust.account _ �•• Name ol financial lnsll tullonwheretotterylundiareheld Amount number Address 0 1 Gry G. Unorganized Areas Is your Charitable organization located in an unorganized area? ❑No ❑Yes (1(yes.pleaseindirale) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned. declare that: IAve are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. I/we agree to use the advance funding for approved charitable purposes oru'y. • All answers provided in this Application.as well as all the information contained in the documents and materials Submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Frincinal Officer Signature - ))CA) ID'� d Pnnl name in full '.; .Title' Business telephone number- ( /l G . .. Oate signing J Providing inaccurate information may render your organization ineligible for advance funding Oueshons? Call i-800-1.i7-0098 Ce forniuioire cs.cussr di;,-<yk 'y_�en(FJngais. � CLABINGTON SWIM CLUB INC. P.O. Box 172 • Bowmanville ON • L1C 3K9 Clarington Swim Club Advance Funding Program Application Funding Amount Requested: The amount requested below is related to loss of revenue from lottery sources(bingo,nevada)experienced since recent changes to Casino regulation brought in by the Province. Our primary financial need is to replace that lost revenue. We are requesting an amount equal to 2/3 of our experienced losses, with the intention of replacing the other third on a self-sufficiency basis. Loss of Bingo and Nevada revenue between 1996/97 and 1997/98 fiscal years: Bingo 96/97 $18,570 97/98 $12,610 Loss: $ 5,960 Nevada 96/97 $40,309 97/98 $23,938 Loss $16,371 Total reduction in available funds=$22,331 Requested Amount: $14,887.00 . 1 Clarington Swim Club Programs and Community Benefits The Clarington Swim Club is in its 13ih year of operation. Beginning as a Summer club,then moving to full year operation with volunteer coaching,the club made the transition to professional coaching in 1989. The club attempts to provide full range service from first time competitors as young as 5 years of age up to Senior National Level. Membership is not restricted in any way other than the need for basic swimming ability and an interest in learning and pursuing the sport of competitive swimming. The club has and is capable of accepting disabled athletes from the community, and annually hosts a competition attended by a team of disabled swimmers from Variety Village. The basic concept of the programs offered is to allow each child to progress as far in the sport as they are willing to work towards. Selection is not talent based,however the club does provide some travel support at upper levels in order to make participation financially possible for those athletes who have reached that level of achievement but might be of limited means. Membership rates for the club are significantly lower than comparable programs in the area. The program includes a house-league(novice)stream as well as a travelling competitive steam(approx.a 50150 split within the membership). The season runs from 9 to 1 I months of the year depending on level of participation. Training groups are divided by age and ability and split between morning and afternoon sessions in two different pools. Children involved in the club have access to a near year round program that provides an encouraging environment,with positive interaction with adult leaders. Swimmers develop many important life skills such as goal setting and time management through participation. The club also has a recognition program encouraging academic achievement as well as athletic. Of course they also benefit from increased physical fitness,with both immediate and long-term health implications. Please find attached a copy of club goals,an introduction to novice swimming,training group descriptions, and a fee schedule showing program rates and obligations. i . APPLICATION $11 °.wro i a".,x roqu.xe. Please see attached page of instructions. 20 r°vrr nrr<.5°a�sud tir°u Ste a+adcosari° _ please print or type — P6A6142 FOR OFFICE USE ONLY: 1. Previous charitable gaming licence Has your organization ever applied lot a charitable gaming event licence? No ©Yes(Ilyes ry What is the most recent licence number issued by: N AGCO: s P ti Municipality: Cr) Have you had gaming event licences cancelled or licensing 9No yes privileges suspended in any juridicalion in the last hvo(2)years? 2. Information on organization eo t GIN unc�- l-c�� l .i ;_�t 41-1 2 a) Incorporated or legal name Street address of orgy nation i city Province \aLA to Pr Postal Codde f�� �7 /Telephone No L. L I I ,q IN 1 ' Postal Code Mailing zddrss(il dif @2r.11 b) Is your organization incorporated as a non-prolit orgamtetion? N —v Yes) s l yes) � Jurisdiction of Incorpontion r:!mber Incorporation C) Is your orcam=.lion registered as a Charitable Oroanization wah Revenue Ca ada? ? No � Revenue Canada Reg number 1 1I 1 I r1 � I I I J) F.ovr long t�s your organization existed? What is the linaMal re:end of your organization Month I Day Years 3. Affiliates Is your orcanization affiliated vvrilh any corporation or organization? _ _ �11 1 t C No [�Yesll)es tislthe legal Names(M1'r_'.h separate sheetifnecessry) - ` 'r•t ` '1R GU.nCI z) b) 4. Use of net proceeds J/ Quo What will the advance funds be used for?(Allachsaparalesheel it neemsafy) alTrc_,MICA SL 41-1 n) Tut' 'neLJ 1r1 C) run Gurren___� caqrtmS d) Oueslions? Cali 1-600-367-0096 Con r,r%jexC cn tDOC% 00 1 �- S 5. Lottery trust account Cy.._ .. _ ' Name at Bnanclal Insiltutlon where lottery lunds are held A=unt number Address city G. Unorganized Areas Is your Charitable organization located in an unorganized area? 1A No ❑Yes (if yes,please indirale) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY BIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER OAYUNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING6NORGANIZED 7. Declaration We. the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receivino remuneration directly or indirectly from I dvance funding. • I/we have been authorized to make this application on behalf of organization. ` • I/we agree to deposit all advance funding into the designated I trust account. • I/we agree to use the advance funding for approved charitable ses only. • All answers provided in this Application,as well as all the infor n contained in the cDcuments and materials submitt ed ovhh it are true and complete. We have read and understand the a Declaration above. Principal Officer Principal Officer Signature 1 -Print name in f - 1-� Title LJ � cPC�r,s � I mac=c-T�2 / C;OeJ 'l3 b - as a7S' I Business telephone er- {G IU I �0, 4 3 t 16, 3,3,0 Date Signin q' 2 19j Providing inaccurate information may render your o lion ineligible for advan::e funding Ouesli�ns? I o�_-isi-0098 Ce lOrnlu.'c,+2 --s:cuss, en lrjnco,s. Durham East 4-H Association is a youth nrganizatiun the primary purpose of this organization being the personal development of youth in rural and urban Ontario specifically Durham East .The 4-H programme is open to young people 10-21 years of age . Locally run clubs are planned to suit the needs in each community of Durham East .Projects include livestock, nutrition, fitness,crafts to name a few.Parents and public minded citizens serve as volunteer leaders and advisors .Our well planned programmes in Durham East strive to provide effective training and experience in technical knowledge,assuming responsibility,co-operation with others . conducting business meetings, constructive recreation and programme planning .Character development,good citizenship and training in leadership,agriculture and life skills are important goals of the 4-H programme in Durham East . Some of our specific activities are judging coaching and competition .achievement programmes,Go for the Gold competitions, youth rallys,as well as individual club activities .We work hard to develop an interesting and worthwhile programme for our youth as we continue to uphold the 4-H motto "LEARN TO DO BY DOING" APPLICATION V2 ITS 0•rails l nI1M rM.r•ild/ zo(Oster Onw,svlr_800 Please see attached page of instructions. $!vb Ste.Marie.nn;dri° PuA 6V7 _ please print or type I 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No VYes(Ilyes) What is the most recent licence number issued by: AGCO: P Municipality: M was- s� Have you had gaming event licences cancelled or licensing g!o EjYes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name l�Ryp�N C�MMi�tir ry CDNTRE Street address of organization Act 7 Gn /C Province . _ r / I > z C rl �,U/ \ 'r� • �Ci,0tilC?AV, le Inc / Postal Code?7 Telephone No. �7 y / fat N0. C Mailing address(il dB'vent) /1 Poster Code 7762 6111 SCttge, 1�14)Cl Z7nnls�� l G'ti' b) Is vour organization incorpomteo a non-pro(il organize on? ER<o ❑Yes(11 yes) lunsdiction of Incorporation number I Incorporation c) Is yocr oroa.:i_.lion registered as a Charitable Organization yith Revenue Canada? �.fNO El Yes(1/yes) Revenue Canada Reg.number I I I I I I I I I I d) How long has your organization existed? What is the financial v--.r end of your organization 7 Month I Day? Years 33t f/ ((mss I Dec J 3. Art iliates 7 Is your organization affiliated with any corporation or organization? ©No El Yes ll yes.- List the legal Names(A:7£ah separale sh"it necess2ry) 2) b) 4. Use or net proceeds r OJ What will the advance funds be used for?(Allachs!p2raleshedilneressary) a) /1eW �t.-fry]UCC! 1l.�rh"� b1 lJl ?7 ��Or_lJ5 �) iY1561�tt�r �;n d) /,Y.Y/1 -Zilai/11,e �P 9CZr!" S Questions? CelI1-600-387-0098 Con linueC on Ooc� O.c O p 001(3L135) 0 5 pottery trust account ._ _ Name of financial Inslllullun where ludery lands are heW - Account number t #41f/cn, t( / 7ruSf �y - 03,qS16 address �;y (8 n%ny S� 6C, tC, d/I Ile 6. Unorganized Areas Iss your Charitable organization located in an unorganized area? EX ❑Yes (11 yes,pleaseirdrrale) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZEDI' ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • Ilwe agree Io use the advance funding for approved charitable purposes only. • All answers provided in this Application.as well as all the information contained in the documents and materials submiu=_d with i; are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal ONicer signature Ly/V4 (°iGUOrr (Mcs� Prinlnametnfull ! , ��t E/}Sll �IQ Title Business telephone number. `�'j ,t-., �7U q fj �.• .Gale Signing /d Providing inaccurate information may renderyour organization ineligiblefor advarl:e funding Ouestjens? Czu 1-600-35I-0098 Ceformur oir==;,cvsstcinponiVeenfranQois. PHaydon Community Centre c/o Lynne Piggott 7762 Old Sougog Road Enniskillen Ontario , LOB IJO Marie Knight 40 Temperance Street Bowmanville Ontario , LIC 3A6 P-'n--Vember 20 , 1998 Dear Marie 1 a!iiy ePire , i am a p p 1 v i n gr fair 8r! I I Ontario Lottery Corporation grant to help fund 'sevpr -� i - ec at the centre . 1 ) The furnace and duct work at the centre is ancient and needs to be replaced . The majority of the money we PeOP- i 've via our fundraising projects goes to heat the building . 2) The building was built as a schoolhouse , 5 . 5 , 1121 Darlington . in 1876 . The windows are probably the originals and leak like a sieve . They need to be replaced . 3) The ceij � ng was lowered and the walls were covered half-way up with varnis d Plywood but no insulation was added to preserve the heat in ei aer area , 4) The roof needs to be replaced and the extremely worn material on the floor in the main area of the centre is the original floor covering , it also needs to be replaced and the floor insulated . The chairs are chipped and catch on to and leave pulls in clothing and the legs of some tables need to be replaced . The Playground equipment needs to be repaired and/or replaced and more items could be added to compliment those already present . The benefits provided by the centre are : a place for the members of "Club 21 " to hold meetings and community events , a focal point to meld the community together and provide Haydon with an identity , a place to hold fundraising events so that the hall can be maintained and charities can benefit from a portion of the proceeds , another income source by renting' out the centre, a place for serving a funeral luncheon to the families of fellows/affiliates of the community or those who are celebrating anniversary/birthday milestones , and a place to gather foodstuffs and other items for a food bank . The building and grounds are kept in good repair by the custodian and the members . The Municipality of Clarington provides some assistance with regards to minor repairs etc . (Fred Horvath) , and pays the taxes and insurance . Haydon Community Centre - 2 - The oentre does not have an assigned operating budget . The funds that are accrued during the previous and current years ( from the fundraisings , rentals , and donations , plus a small mutual fund investment ) minus expenses are those which the centre uses to operate. The numbers of members is diminishing as their ages are advancing . New members are slowly being recruited so that we will have new ideas for fundraising and a wider base of volunteers to draw upon . The older members are getting tired of working diligently for long hours only to see their efforts literally "go up in smoke" ( up the chimney in heating costs ) . Some of the members actually attended school in this building and one member taught school here . You can certainly understand that the nostalgic sentiment regarding the centre runs high in this group . When the school was closed , they applied for and were granted permission to use it as a community centre . The members are hopeful that ou will award a substantial grant so that the centre can remain o en for the sake of the community . Please find enclosed the application form, a list of the board members , a list of the members , the original bank account statements for 1997 , and the statements of account for the mutual fund investment for 1997 . Sincerely yours -7, - +,7t,6 /it Lynne Piggott (Mrs . ) Treasurer Haydon Community Centre Enclosures I �I i ROSTER CHARITY I • IN - ADVANCE FUNDING ® lsnj_ APPLICATION 113 N"LSIWCWIp . 0tl'"'°'•"°ite800 Please see attached page of instructions. 70 Foster Dim,Suite AOD Sault Ste.Mane,Ontario P6A 6V2 — Please print or type — 1. Previous charitable gaming licence FOR OFFICE USE ONLY: Has your organization ever applied for a charitable gaming event licence? No F—]Yes(ffyes) What is the most recent licence number issued by: AGCO: P Municipality: M 0-CI y Have you had gaming event licences cancelled or licensing No [�]Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name D A oN0 If Arlf 1 t)A Af 7 ,41�714 A L5 0C1Yrls Street address of organization City Province '00RIAllf dss %kA"fr DAON0 Fie)/)/7 Postal Code Tetephone No. Fax No. 0 0 ( o L57-) ? /- ( 1 1 ) Mailing address(if dillerenf) Postal Code b) Is your organization incorporated as a non-profit organization? ❑No ❑Yes(if yes) v Jurisdiction of Incorporation number 91 $ ?p Incorporation 0 N 7/94/ D c) Is your organization registered as a Charitable Organization with Revenue Canada? No ®Yes(If yes) Revenue Canada Reg.number 0 I `f I I 1 D 13 1 71 O 19-1 6 1 / 1�7_I d) How long has your organization existed? What is the financial year end of your organization Month Day Years y',2 yR f `7!y og axa7,t1J 71- 09- a8� D L i7 M B rR 3/ 3. Affiliates Is your organization affiliated with any corporation or organization? ®No Yes If yes: List the legal Names(Attach separate sheet it necessary) a) b) ((�� 4. Use of net proceeds A Mot l (JT TRE_j V,9_S_r F_M 5pr oc�c What will the advance funds be used for?(Attach separate sheet if necessary) a) d d,01 i 1 uw To /64� 5nl i N/�1.�1� b) ( G- L. r. :riz C) d) Questions? Call 1-800-387-0098 oic GAP 00 t(9et05) Continued on bock 5. Lottery trust account Name of financial institution where lottery funds are held Account number (11k,#121,441 Tin :.4/Z vk t F Co = C ' °7/e o, o / Address city 6. Unorganized Areas Is your Charitable organization located in an unorganized area? L7 No Yes(pf yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer ✓J Principal Officer Signatun Print name in full /�r 4 Tille 9 1 —1 I.�I� O 5 / IJ Business telephone number I I�I A v s T- l 7� / 9 y Dale Signing Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formulclre est cuss)disponble en frangais October 20, 1998 Municipality of Clarington Clerk's Department 40 Temperance Street Bowmanville, Ontario L1C 3A6 RE: GRANT APPLICATION We, the members of the Orono Athletic Association, are requesting a grant in the sum of $50,000.00 to help assist with the expansion of the Orono Arena and Community Centre. In 1997 Bel-Con Engineering Ltd. Submitted blueprints for the expansion with an estimated cost of $210,000.00. Since this project is planned to break ground in the spring of 1999, a 10% increase in the initial cost is anticipated. Therefore, the total cost to complete the desired and much needed expansion is $230,000.00. We have enclosed all the required data to support our request. As you are aware, the village and area residents have, in the past and will continue in the future, contribute the bulk of the funds required. This fund request represents 21 .7% of the total estimated amount and is certainly deemed a reasonable request. Sincerely, Orono Athletic Association I Orono Amateur Athletic Association "Incorporated" P.O. Box 165, Orono, Ontario LOB IMO Our primary object is the promotion of amateur sports and recreation for over 600 youth of the community. The accompanying letter explains the need for an addition to our present facility. You will note that our responsibility under the purpose and objects section of our Letters Patent is also to do things that are conducive towards accomplishing those goals. If we receive a grant the funds will be used to help us attain this goal. I a a fi I'4 P.O. BOX 165, ORONO, ONTARIO LOB-1 MO Place Date Here Corporate Name and Address Dear Friend of the Community; The Orono Amateur Athletic Association's recent hockey registration, has shown a ten per cent growth in the number of players. A similar growth in figure skating has occurred. This growth in usership has many positive benefits for our community. Keeping our youth involved in sports makes for a pleasant and safer community. This increase has begun to put a strain on our existing building. More skaters and hockey players, more female membership on rep and house league teams and an ice surface that is very rarely if ever left empty requires the expansion of the support facilities. At a recent meeting of the Orono Amateur Athletic Association, it was decided that two more dressing rooms, more equipment storage and a multipurpose room are required to keep up with the present growth. Two new hockey teams will require storage space for equipment and sweaters. Eighty to ninety Can-Skate youngstersand female team members require more change room space. Parents, teams, officials, coaches, committees, Fair Board members and the Association require a room separate from the busy community hall to meet for a variety of reasons such as safety instruction, planning and other presentations. This addition will require a capital expenditure of approximately $ 210 000 . We would prevail upon your generosity in asking that you make a pledge to support the building. Once we have $100 000 in pledges, we will break ground on the construction. All donations are tax deductable and sizeable donations will be recognized in an appropriate manner in the new addition. We would be most appreciative of your assistance and look forward to your support. Sincerelv Ray President, The Orono Amateur Athletic Association ( 905-983-5584 ) APPLICATION 414 o.urlr leneq prywtllo� 10 Fo 1e,011w,S w'a BOO Please see attached page of instructions. Cvb Ste,Madc.Onculo P64 6V2. - Please print or type - 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No El Yes (Nyes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No nYes privileges suspended in any juridication in the last two(2)years. 2. Information on organization GIN a) Incorporated or legal name n � 1 K AR i � r ZIMrgvri :/� I Ire I address of organization i city Province ,r• r �Z>X � 1 ,7 Ike")M N I J, .. ClWj_liMt Postal Code ! Telephone No. fax No- 1 Ir > . G i / // q Jn _ . L1 in i t l9tbl� ) lu,al� l tc/,H-I/ , � ( t ) I I 1 - I t t , Nalltng address (difillezecl) Postal Code AyY1C i 0/y C ! c 3 b) Is vour organization incorporated as a non-profit oryanizaa on? No Yes(I7ys) Ju:isdicti n of In[sporalioo r.uclber Irccrporatian c) Is yocl orca .!-ii n r= istered as a Charitable Ordanizalionealh Revenue Canada? Noes Revenue Canada Rag number I I I I I I I d) 1-.ow lono ras your organization exisled? What is the financial r :end of your organuatian onth I Dam Years I y s/�� (�/(/�l MAE�_ 3. Affiliates Is your ore2nization affiliated with any corporation or organization? O Nc Yes ll)2s List the legal Names(AL'1h separaf^sheet it necessary) aI �O��fiil, `� ZNl�i2111�ATlE�Nf�/_ b) t--rl5 7? 7�L ,)e X167 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet i(nevssary) aI �r�M/�9uNil� �% �rJ�Gc e) JT /S�BZc=D �NiL-7�i� o . te a yr ±Ine d) G«6s )C" f L��.r ync C) s (C Srfit'/e S 11e7� Scflc�( r�rdDC�i/icS (F) � .a LiI C4I[�E Ou eslidns? Cali 1-800-387-0098 Conl,nu on 00CR :.:aP poi pnao� Ly 5. Lottery trust account . , : • Name of Handal Instltutlon1where lottery cco funds are held Aunt number Address city ��J h/N67 5r Ci�S /- 24 JLc Me if Z10 G. Unorganized Areas I. Charitable organization located in an unorganized area? No ❑Yes (11 yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAYUNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We.the undersigned. declare that: • [Ave are a Principal Officer of this organization. I/we are NOT receiving remuneration directly or indirectly from thlIadvance funding. • Ihve have been authorized to make this application on behalf of Ile organization. • Ilwe agree to deposit all advance funding into the designated Iobry trust account. • Ilwe agree to Lrse the advance funding for approved charitable pjrposes only. • All answers provided in this Application.as well as all the inforration contained in the documents and materials submined with I; are true and complete- We have read and understand the erire Declaration above. Princioal Officer 77 Princripal.Officer Signature 1 -Print name in fd' �c�n s ch' CCcc 11�c t�F111 A� D o n Title -: i — I�A1I / I� Business telephone,lmher," 101 613 1 I /�j Oa leSigning _- Providing inaccurate information may render your o nization ineligible for advance funding Queslr.-s? cc;! i_000-3.i7-0093 Ce lormu(a2 ?;:cvssr en (17n(Ais. APPLICATION #15 O.b.IS1anM 4ry«tllo. ' rweN,••r«.�..,.,..,.�. 25 orosrcronK.s acaon Please see attached page of instructions. pq Q SSvn An Mad,.nn;a,i° _ please print or type NA 6V2 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? ❑No Yes (11 yes) What is the most recent licence number issued by: AGCO: P Municipality: `) M Have you had gaming event licences cancelled or licensing No O Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name Sc�� /NA 0rYIIY)arL' CtN?�b I�er+r2D Slreel address of organization Ciry Province _ Pr-z�i✓ a/t - Postal Code Telephone No. fax NO- LI I I l 1 131ccj��I / I � f Ic ,S ) I� 131 — I°ll�f 1617✓ ma:rrg address f.!d�IfP2c1) I Postai Code 1 1 b) Is your organiation incorpoated as a non-prolit organintion? 'QNo Dyes(11 yes) Junsdicfion of n Ccrvo2fi0r.r.! lber I Incorporation C) Is your oroa-!-tion registered as a Charitable Oroanizalion with Revenue Canada? Z--No ❑Yes (Ilyes) Revenue Canada Reg numb, d) r.oa long has your organization existed? What is the financial y_r end of your organization Month I 3 y Years G-l� ,S6 ra.ec / 3. .Affiliates Is your orcznization allifiated with any corporation or organization? F]�No Oyes ll)2s: List the legal Na@es Pi E::h Sepa/aL^s:heel i/necessary) al b) 4. Use of net proceeds tVnal will I e advance funds be used tor?(Allarh s_°parzie sheet ilnerasary) t,(t�v�.� Q 0IE STEM v , OC ��RK lA7P DEErYrEti'Ts (CP6K'aDCS b) lzr/L- ZoT+ d) Ouesfians? Cats 1-800-387-0098 r;pn!inua:M occ� :.:L:POJi Co! 5. Lottery trust account -. - ' Name of financial Inslilulion where lottery lulls are held Account number ' . • vt �l 13�rti'K 36,.)� - Address city 6. Unorganized Areas Is your Charitable organization located in an unorganized area? t2'No n Yes (It yes,please indicate) 0 ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED F] THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED F] TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned. declare that: • 1/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated loeery[rust account. • I/we agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application.as well as all the information contained in the documents and materials sub=:Ied vrflh i; are true and complete. We have read and understand the entire Declaration above. ( Principal Officer Principal Officer Signature, .,. � �� �a� -Print nami in full, Hr,< (3 e2 f NW Ink' !)«F F -'Tille - CH/�1RfER Son) q St Cefi� zy � _tjSrc�fK q i — 191 I ) Business telephone namher: I l ;41 31 — 19 13 d I C P Date Signin z r Providing inaccurate information may render your organization ineligible for advarl:e funding Quesi!:.as' Czr, t-800_3s.__0098 Ce(ornnu!crn_;;cussr en(rOnc.Ors. I SOLINA COMMUNITY CENTRE BOARD C/O DEANNA MACDUFF 1914 CONCESSION RD. SIX HAMPTON,ON LOB 1J0 November 20, 1998. Municipality of Clarington Clerk's Department Re: Ontario Lottery—Advance Funding Board of Directors Chair person - Herb Tink Vice Chair Karen Dair Secretary/Treasurer Deanna MacDuff Two members from each of Recreation, Park and Hall Committees. These members rotate on occasion. We have several activities in our community. The park is used for lobball, softball, and soccer. This summer, we had 3 children's ball teams, 3 men's teams,and 3 ladies teams. We also had 5 children's soccer teams,and 2 adult teams. We presently have 2 ball diamonds,and a soccer pitch which can only be used when there is no baseball on the second diamond. This basically eliminates practice time,because of the shared area. We also have a tennis court,and basketball net,and a children's playground. We own more land at the back of our park. What we face now, is whether we should try to develop this land, or go to flood lights for our ball diamond. Our community has tripled over the last 10 years,and a new subdivision is presently being built. We feel that it will be very difficult to accommodate more children without having a dedicated soccer pitch. Another local organization has discontinued their soccer activities,and several children from this area are now coming to Selina for their sports. We would like to put flood lights around 1 diamond,which would allow us to have 2 games a night on this diamond, and this would then give us a dedicated soccer pitch during the week, and the two diamonds for weekend tournaments. The cost for this will be in excess of$100,000.00. Also, we have a fence that needs to be replaced. To do this with a good quality chain link fence, it would cost us another$9000.00. Our hall serves all age groups in our community. The hall is presently being used for 4H, cubs, and WI meetings, all without cost to them. We also have a seniors organization,the Silver Set,which accommodates these people for meetings, and luncheons. This is a very active group as well. Also, it is used occasionally by our Church, for Christmas concerts, and Vacation Bible School in the summer. This event was extremely well attended by children in and around our community. I \ _i There are also card nights on Fridays during the winter months. Our hall is handicapped accessible. Three years ago,we put in an elevator for the use of people who are physically challenged. This has allowed many of our local people to once again attend functions at our hall,where they were previously slut out. The hall is rented out for dances, showers, and weddings. The banquets are all prepared and served by volunteers. This allows us to make money to basically cover running expenses for our hall. Our hall now needs to have the parking lot repaired. We have been checking out prices for thus,and it appears that we can have half the lot done with recycled asphalt for approximatley $12,000.00. This quote will have to be verified in the spring. Both of these projects will be major expenditures,which will require assistance. In order to complete this work,we are requesting funding for$125,000.00. Thank you for considering our organization for advance funding for these projects. Sincerely LM Deaura MacDuff. Secretaryfrreasurer. • • DVANCE FUNDING aawL.rrerr t..v.a.. - APPLICATION #16 to FOarerOnre,score 6Gh7 Please see attached page of instructions. Saul!Ste.Marie,Ontario PSA 6V7 - Please print or type - Da[@-p �nz / Time CS) 3 R To �L".LL. -_ LE YOU WERE OUT Pr�v nce -e N From r}�� �G/;, . _ KK Company �•` '�— - * — D 7 Postal code Telephone 3 -- f L, -L— 5 � / Fax - Jb ✓- MESSAGE ` rorganization i�'Ly��/ •_i Month -31 Operator --- --- 138LL43JW nlwr OLC CAP 001(98105) Continued on back v f. 5. Lottery trust account Name of financial institution where lottery funds are held Account number i A 46 Ad ress _ city ' — c- 6. Unorganized Areas Is your Charitable organization located in an unorganized area? }�No []Yes(If yes,please indicate) r 7 ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED 7 COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED 7 KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. 1f•-!(V • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Sipotaro Print name in full S Tine COQ a Q DIRE c T D 71 1317131 osi nness blephonumber 612-13,5) — I I Q 3 1 9y1 �� 61 91 — ne, cgl �l Al Ad OiteSisnln0 A Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponidle en franpois. Curriculum Connections (Educational Outreach) pARTners PURPOSE: to provide links between community groups, the municipality, and local schools • building positive relations between schools and community • encouraging community pride and involvement among students, teachers, and the greater public • improving the quality of life in the community • arts advocacy in the community Projects include: • Art in the Atrium - the creation of two temporary hanging installations in the Courtice Complex (following the successful Fish Project); • Anti-bullying Project -Auntie Violet's Decision (for 25 schools)Picture-story presentation with music plus artists' workshops.; • Dance project with Bowmanville High School and elementary schools - Dancing the Science Curriculum Senior dance students from Bowmanville High School lead workshops in Plants/Animals (Gr 2-3) and Energy/Control (Gr 5-6). BUDGET INFORMATION Art in the Atrium (costs for each of two projects) Expense Items Expense Projected Revenue AMT Revenue AMT Sources Artist/instructor $1200 Lions Club $750 ($150 per diem, 8 days in school) Materials from $300 Schools $300 school Materials $150 OLC $750 (beyond school supplies) Coordinators $100 (Educational Consultant& VAC) Total $1800 $1800 Anti-bullying(visual artist, storyteller, musician) Expense Items Expense Projected Revenue AMT Revenue AMT Sources Artists Fees for 7500 VAC studio use 200 25 class visits (in kind) Coordination 300 School& 200 artist's supplies (in kind) Supplies 200 Optimist Club 3900 Rehearsal space 200 OLC 3900 Total expenses 8200 Total receipts 8200 Dance Project: 10 sessions 5100 =$1000 Total funds requested from OLC for pARTuers projects: $6400 Rivercairn by Rowena Dykins purchase price: 55000 from exhibition at the Visual Arts Centre, April 19 - June 5 1998 The water of Soper Creek, which winds its way past the Cream of Barley Mill, is a major element in several works in The Real Mackay exhibition, most directly in Dykins' white cedar construction Rivercairn. Its patterned surface emulates the movement of waters that meander or rage past, depending upon the season. A five by seven-foot beehive shape, it speaks for its antecedents: cairns were burial mounds, storage devices, markers and focal points for ritual activity, sometimes related to astronomical phenomena and the changing seasons. In Greece they became road markers, symbols of Hermes the messenger who took dead souls to the underworld, —the god of travel and patron of travelers. As architecture developed towards the use of timber framing, sections were enjoined with doweled components, and cairns were carved and decorated. Dykins is working within this tradition, using a doweled construction, and incising water current patterns on the lower exterior. For Dykins, whose ancestry is Welsh, cairns are personal reference points for identity, reminders of past travels, and an ongoing element of her artistic practice. In A Lost Tradition: The Nature of Architecture ill Ireland, Niall McCullough and Valerie Mulvin point out that the circle is common to many primitive societies, used in the construction of huts and the delineation of an enclosure for ritual, defensive or domestic use. It is at once the most economic and the most perfect of forms . . . naturally emulative of the sun, the moon, and the pattern of the seasons. . . . complete and unassailable at anv scale. 1 Their description of certain burial mounds in Ireland as "ordered and centralized, . . . secret and without access - closed" aptly describes Rivw•cairn, mute, massive and in its simplicity, a tahula rasa for contemplating the passing waters, a marker for recollections of other markers, a mystical piece that elicits its own aesthetic force field. 2 Rivercairn connects to other pasts and mythologies, with the notion of ongoing movement, flow, and change, and in the sense that Rivercairn represents the furthest reaches of memory and record within the context of the exhibition, it can read as marker for the rest of the show. As a long-term installation, it would make a stunning addition to Soper Creek Park. Endnotes 1. Niall McCullough, and Valerie Mulvin, A Lost "Tradition: the Nature of Architecture ill Ireland(Dublin: Gandon, 1987) IT. 2. Ibid. Staffing Upgrade Marketing, promotion; and special events coordinator 10 hrs per week c@ $10 per hr. For 20 weeks= $2000.00 Gallery Improvement Vestibule carpet: Room darkening blinds for daylight slide/film presentations: Quote from Restorama $852.79 r Visual Arts Centre of Clarington Staff List Curator Director: Margaret Rodgers full time Administrative Assistant: Linda Ward permanent part time Bookkeeper: Deanna MacDuff, Administrative Office Services independent contract Art Rental Consultant: Irene Lubowitz commission Curriculum Connections Liaison: Anna Luckai commission 1 ® wr CHARITY ROSTER ADVANCE FUINIDIN% OehMLafey talraretla APPLICATION #17 0Fostearrl S 6890`10 Please see attached page of instructions. 70 Foster Driw.Suite 8L17 P 9 Sault sle.Marie.Ontario Feaevz - Please print or type - 1. Previous charitable gaming licence • ' Has your organization ever applied for a charitable gaming event licence? _RNo Yes(!(yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing ❑No Yes privileges suspended in any jundication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name - ,- �Ilzhtivrn�c� J%!_lam - Im Street address of organization City Province or\) Postal Code Telephone No. Fax No. Mailing address(if different) Postal Code b) Is your organization incorporated as a non-profit organization? No nYeS(dyesl 4 7 5 1, 7L1 Jurisdiction of Incorporation number Incorporation )r� (l-1`r� �L'r 1^.(.�✓^ `� l c) Is your organization registered as a Charitable Organization with Revenue Canada? No Yes(I(yes) Revenue Canada Reg.number d) How long has your organization existed? \ What is the financial year end of your organization n�Month Day Years 3. Affiliates Is your organization affiliated with any corporation or organization? E No M Yes l,`yes: list the legal Names(Attach separate sheet it necessary) a) �l�2.�^,�t/'Pr�1A� SOC_iQ,V--{ �tC I�JV`�G/'(CJi b) 4. Use of net proceeds What will the advance funds he used for?(Attach separate sheet it necessary) r Skl�l n z Oc �rio.(��1. IlbtrGt ��IDY�si�.0 �.rr� Alzha Lv�-r �r °+- r2-tzlu,l nbir. d) =.a Questions? Call 1-800-387-0098 OLC CAP 001 (9er05) -ontlnued on 1=, 1 5. Lottery trust account — Name of financial institution where lottery funds are held Account number f0 ddress city ILi+-,(j �'t l 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ❑No 7]Yes(d yes,please indicate) ALGOMA UNORGANIZED 7 PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED 7 RAINY RIVER UNORGANIZED KENDRA UNORGANIZED 7 SUDBURY UNORGANIZED 7 MANITOULIN UNORGANIZED 7 THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED 7 TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature tl�l(r6n_ Print name in full � � Title �xcr✓ l� ll*2 �1VeC 6Y (ll j r Business telephone number (_I QQ c 7 I�� Date Signing Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 CefornnuiareesrOUSSIaisponioleenfrcnGois Alzheimer Alzheimer Society of Dumam Region Oshawa Executive Centre Suite 205 419 King Street West Oshawa.ON -1J 2K5 Bus. (905)576-2567 Fax. (905) 576-2033 November 26. 1998 Ms. Marie Knight Clerk's Department, Municipality of Clarington, 40 Temperance Street, Bowmanville, Ontario LIC 3A6 Dear Ms. Knight, Enclosed please find a budget breakdown for our request for funding available under the Advanced Funding Program of the Ontario Lottery Commission. Our total request for funding is for $10,000. 62 families in Clarington utilized Durham Alzheimer Society services in the past year. This represented 20% of our caseload. Of these,33 are currently active. An additional 25 persons from Clarington also requested information packages from the Society. Also enclosed is a cheque for $25-00 for processing our application. Thank you for your assistance with our application. Sincerely, Brenda McConnell encl. Durham Alzheimer Society of Durham Region Funding Request- Budget Advanced Funding Program - Ontario Lottery Commission Item Amount Support Services Expansion • establishment of a satellite office • establishment of a support group for caregivers • promotion/advertising • honourarium for space utilized • staff/volunteer expenses-travel, salaries, training • telephone expenses • program supplies $9500.00 Establishment q1 Portable Library Program • purchase of contents: -books, videos, pamphlets, 500.00 Total request: $10,000.00 1 APPLICATION #18 AavANcE FUNDING v CNAiarry Rosniz APPLICATION alecsa sea arached page or lnsfrucrlons. �ar�ror�srmae ]Y+I]i YIIG'i`m'U' . . Please print _. a ,fpe - 1. Prawous charitable gaming licanese , as/bw^r nia::cn aver applied tar a cnantacle yaruno°•lent Itcence? VNo FL yes"aM) What ise mast rerEm licerc_-umner staid oy: Tanuary 2 8. 19 8 AGCO' P P980550 Municipality: M Have you nad gaming event licences cancei ed or licensing T No G yes privileges suspended in amr Iuncication in the Iasi two(2)years? I 2 Information on orgeniartion ` GIN a) Incorporated a Wo name AUT'I&M SOCIETY CN ARIO 1 i Durham Regional Chapter AI S I He 0 13 1 51 8 street addrrsss at oraan1=011 Ciry, Pro�nnd 1 Greensboro Dr. Suite 306 Etobicoke i CN postal Coca - I Tekpnane No. Fax No. 246-19 MI 91 W 1, _CI 8 (416 J 246-95921 1 4�6 I J 1 1 1 — 1 I Malang address i✓Wtheta) I I Postal Code b) is your arganiamn incorporafeo as a non-orate aiganimtion7 No yes(?I yes) :unsaicean at Incoroaranonnumber 271183 Inmrooration CNrARIO q Is your organzation retasretM as a Charitaoie Organization wiln devenue carow El Na Yes(!f Yes) Stfieme Canaa Seq.number 0 4 1 11 5 1 4 r 61 3 1 –t 1 1 1 b) Hmv long nos your or w awn actitea? What is the financial year end of your orvanilation Month Day Years 25 years 3 31 3. affiliates is your organization at ifiated with any coroeradon or drgarvmtion? YNo [,I Yes Ayes: Us!!fa/ego!M1'ahxs(Agat113!Carafe Sheet:!r:.assaryJ a) b) 4. Use of net proceeds Whatwill me advance funds be used far?i,=seen.snxr !ne4ssry) a) Members Services Manager iI See attached c) d) Qaesfions? Call t-dOG-?97-GG98 atc rvr oor(sws) Con^r�eC C� -F r S. Latter/trust account ' .Vine Of tiraW=1==:jCn caner.'crry tunCS ax`tlC iACCCCat numoer 1002120 'CYAL 34NK OF CWLA Aedr= aty Thornhill Ontario 8185 Yonge Street S. Unorganized Areas Is your C-?ntanfe Organiandn laated in an unorganized aces? No I Yes;."•;xs,plssa,;'adrr^1 ALGCSIA UNORGANIZED ❑ ?AR9Y SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED (] 9AINY RIVER UNORGANIZED 71 KENORA UNORGANIZED SUOBUP.Y UNORGANIZED G MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED Q NIPISSiNG UNORGANIZED TIMISKAMING UNORGANIZED T. Declaration We, the undersigned.declare that: • lAwe are a Pnnapat Officer of this organsaticn. • Iiwe are NOT receiving remuneration direct'or indirectly from the advance funding. • IAve have been authorized to make this application cn behait of the organization. • ONe agree to deposit all advance funding 4td the designated lottery trust acccunt. • Uwe agree to use the advance tundino tar approved claritable purposes only. • 1pwe will sponsor table game events at the local cnany casino. • AN answers provided in this Application, as well as all ra information contained in the documents and materials submitted with it am true and complete. We have read and understand the entire Declaration above- Princi al OfReer Principal Officer Slgnahue . � Print name M full Vernon Georg Rhap, Samil,at Chair, FundraLsing t,oDmittee wte Board Member Office Manaeer Busines tephone number ( 4 l l r 6 � 2 ; 91 61 — 1 9 1 51 9 x 2 s el (4 i i i R) 2L4 16 r _ B I S i 9 l 2 September /(a , 1998 Oarasigninq September 1998 Providing inaccurate information may render your organization ineligible tar advance funding Ouesrioas? Call t-a00-3a7-009a Ca t;=Ufciie es;cussidrspCnC:2 enfrr;'C"S. A U T I S S O C ! E T -f O N T A R 1 O 1 GREENSBORO DRIVE., SUITE 306.TCRONTC. ON M9W I C8 • BUS: (416) 246-9592 • FAX:(416) 246-9417 E-MAIL aucismon(a pass po r-,.:a FH'ARFAB Y7 REGISTRATION NO.0415463-11 J 23 aM October 30, 1998 The Clerk Municipality of Clarington 40 Temperance Street Bowmanville, Ontario L1C 3A6 Dear Sir or Madam: Please find enclosed Autism Society Ontario's Charitable Roster Application - Advanced Funding and supporting documentation. Autism Society Ontario is a not-for-profit corporation registered in the Province of Ontario and a Registered Canadian Charity. The Society operates self-help groups in which parents of children with autism provide community-based support, information and services to those with autism, their families and educational institutions and decision makers. The work and activities of the 25 Regional Chapters are supported by a small provincial staff. The purpose of the application addresses the need for financial support for the Member Services Manager who is pivotal to the work of the Regional Chapters. An Executive Summary Position Description has been included for your information. The Durham Regional Chapter meets monthly to provide education and information workshops. The Chapter supports children and adults with autism and their families. This past summer children with autism attended Scott's Place. Additionally, ASO Durham Regional Chapter hired two students with the assistance of a federal government grant and provided an adult/adolescent summer program and respite and time-out opportunities for families with young children. HONORARY PATRON:THE HONOURABLE HILARY WESTON. LIEUTENANT GOVERNOR OF ONTARIO -2- ASO does not receive grants or purchase of service funding from any level of government nor are we members of any local or regional United Way campaigns. Your assistance in helping ASO to defray some of the costs of services and support provided to persons living with autism in your community would be deeply appreciated and we look forward to working with you to enhance the quality of life today and, give hope for tomorrow for persons with autism and their families. Sincerely, Jr T.C.B. Williams Executive Director encl. C.C. Lyn Kyneston President Durham Regional Chapter i A U T I 5 M O N T A R I O 1 GREENSBORO DRIVE -LITE 306.TORONTO ON M9W 1 C3 • BUS:(416) 246-9592 • FAX: (416) 246.9417 E-MAIL:auusmon(apass port.ca Nov CHARITABLE REGISTRATION NO.0415463-11 U !1 58 PN 198 November 23, 1998 Ms. Marie P. Knight Municipality of Clarington 40 Temperance Street Bowmanville, Ontario L1C 3A6 Dear Ms. Knight: Further to your letter of November 6, 1998 Please find attached: 1) Executive Summary of a position description for a Member Services and Chapter Develpment Program; 2) the processing fee; The Durham Regional Chapter supports persons with autism and their families living throughout the Region. Special Education Advisory Committee representatives serve on every Board of Education in the region. The representatives advise the board on issues related to the care and instruction of children with autism. There are families living in Bowmanville with children with autism. The nature and extent of the support for each family varies depending on their needs. The Regional Chapter provides a summer camp program and has been successful in acquiring funds to provide respite care. The operating costs for the member Services and Capter Development Program is projected in excess of$105,000 per year. Autism Society Ontario would ask that the municipality consider assisting ASO to offset the costs to whatever level you are able. Any contribution, regardless of the amount will be directly applied to the program. I hope these comments are of assistance. Sincerely, I . Williams utive Director HONORARY PATRON:THE HONOURABLE HILARY WESTON. LIEUTENANT GOVERNOR OF ONTARIO A U T I S M 5 O i E ^ �: r A R I O I GREENSBORO CRIVE.SUITE 306.70RONTO,ON M9W ICS - BUS(416) 246-9542 � FAX.(416)E-MAIL auu¢monQpauporcca CHARITABLE REGISTRATION NO.04t5463_t t Executive .Summary .Member Services and Chapter Development Prnar(Im Alemoer Services:Manager The Member Services Manager is a pivotal staff position providing both individual services to children and adults with autism and their families and group development services to local groups of parents, service providers and decision makers. The Autism Society Ontario (ASO) has 25 community-based regional chapters and has set a target of establishing a u-rther 20 chapters by the year 2 00 1. ` The Member Services Manager: 1) manages the development and distribution of the Parent Education Package and provides direct support and consultation to parents 2) manages the development and distribution of a kit for teachers of children with special needs and provides direct consultation to teachers 3) develops a directory of local resources for Regional Chapter use 4) recruits, trains and manages the Special Education Advisory Committee (SEAL) volunteers and provide direct support for their work with 66 Boards of Education 5) recruits, trains and supports local volunteers and provides support for the development of Regional Chapters throughout Ontario 6) organizes and delivers education and training workshop to parents, educators and community decision makers The Need One in 500 children are born with autism and pervasive development disorders (pdd). The thousands of Ontario children with autism seek the opportunity to participate as fully as possible in society. Autism is a life-long condition, the need for early diagnosis and intervention. education and, in adulthood support and training is essential for ensuring an optimal quality of life for individuals with autism. The Member Services Manager plays a vital rote in facilitating access to services, support and information to families and education and information to community resources. HONORARY PATRON:THE HONOURABLE HILARY WESTON, LIEUTENANT GOVERNOR OF ONTARIO The Autism :Vember Services and Chapter Development Program Annually: 1) creates. produces and distr4 , f7:-0-' c'f!ucation Packages' '_) creates and distributes a `Volunteer Handbook' 3) through the Provincial 'hot-line' provides information and referrals to community resources 4) develops and distributes a 'Directory of Local Services' 5) establishes liaison with government ministries and maintains a working relationship with these ministries to ensure effective communication and solutions to issues affecting individuals with autism 6) conducts regional chapter visits and volunteer leadership development sessions Program Budget (1) Member Services Manager Compensation $60,000 (2) Regional Chapter Site-Visits and Volunteer Leadership Development Training S 7,500 (3) Presidents' Council Meetings $ 3,000 Semi-annual (Travel/Accommodation) (4) `Parent Education Packages' S 2,500 (production & distribution) (5) `Volunteer Handbook' S 2,500 (production & distribution) (6) `Directory of Local Services' S 2,500 (production & distribution) (7) Administrative Support S 15,000 (8) Operations Costs 1 12,100 Total $105,100 APPLICATION #19 O�illle(o/IeryCOgOleNe� SWl1//ea IWMeI Ie I'Oe/Wa /a Foster Or7.e.sude add Please see attached page of instructions. s:,asre.Mate,oN;d°6vz rs�t - Please print or type - 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No iBYes (11 yes) What is the most recent licence number issued by: AGCO: Municipality: M Have you had gaming event licences cancelled or licensing No F]Yes privileges suspended in any juridication in the last trio(2)years? 2. Information on organization GIN a) Incorporated or legal name � G IZ/�� Slreetaddress of organization i city Province SAS C , <7 /-f -5%' Postal Code I Telephone No. fax It:e. %0 J llCI jF L� 1 � 31C Mailing address(7ddfe(erl) Postal Code I I I ( I I b) Is your organization incorporated as a non-profit orgarrirlion? No Yes(11 yes)/�CC'zrz -� �' F C/✓-ff�'rc� 4 Jurisdiction of "� Incorporation number �S/�/� Incorporation 1114'1 Si/� CF CctiSt�.n > COII/�4�C/� C� c) Is your organization registered as a Charitable Organization with Revenue Canada? p El No [1]/Yes(!f}asl I Revenue Canada Reg number 1 V/ i 0 I �I C 1 913 d) How long has your organization existed? What is the Iinancial sue:end of your organization Month Day Years 3. Affiliates �(Y�p<)�T ��r-�V�S'r�D a) Is your organization fliliated With any corporation or organization? ❑No,�; dYes If yes: List the fegai Names(wr_a7 separaL s:7eel if necessary) a) Yom// 6 -�/.S/F2-'.S C<F 0. p) .F�/L -/5�e�'S O/' 4. Use of net proceeds What will the advance funds be used for?(Attach separata sheet it necessary) a) b) C) d) Questions? Call 1-800-387-0098 Continued on bock ac CAP 001 oe,os) 5. Lottery trust account _ Name of financial Institution where lottery funds are held Aaoum number /73Zi3t�i�c l.>F�r�ii /3 - c Cl�? '/f/J9 ? /9�39 L iy / c�,n 3/ 8 Address city 6. Unorganized Areas T Is yo r Charitable organization located in an unorganized area? . . No E]Yes (11yes,pleaseindirale) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature i - -Print name in full /� } L\1r�n lj-O .,C1c' Title T- �XEGu jevE (C( �J Business telephone number: �. lC h� ) / I°Z 1 -1— l� 1-3 IU Ic- .. ,I (9 lot-� )J��1rPo�I — IQ la 11+1I S. -.�7/9. oatasigning 'Q_+0L' C J -10 Providing inaccurate information may render your organization ineligible for advan'te funding Queslidns? Call I-800-387-0098 Ce formu'Aire as.,cuss,drsaoniVe en fronQOis. Big Cr Sisters Oshawa-Whitby-Clarington 555 W<nlwon Registration#11880 9391 RR0001 Street East,M Oshawa,On. WH 3V8 (905)715.936 Fax 725.8561 go October 27, 1998 1n°tl1Nim Municipality of Clarington 40 Temperance Street, Bowmanville, Ontario L1C 3A6 Re: Advance Funding Request $38,000. from Ontario Lottery Corporation Charitable Registration# 11880 9391 RR0001 Ontario Corporation# 659216 Dear Sir/Madam: Please consider our application for advance funding while perusing the attached documentation. Over the past year we have received a decrease in funding from United Way in the amount of $37, 672.00 (by the end of 1998). Our other funding initiatives - personal donations, nevada, and special events have also been steadily declining. Enclosed you will find a scale of the steady decline that we are experiencing.(Addendum #4) Big Sisters O.W.C. requests that the Municipality of Clarington consider a donation through the Lottery Corporation monies, in the amount of$38,000. to supplement the shortfall received from our United Way funding. This amount will enable us to go forth with our fundraising initiative (Addendum # 6) to ensure a more lucrative financial future. United Way has historically only funded direct programming of the Big and Little Sister Programme. All operating costs must be raised by the agency. Given the drastic decrease in revenue, the general operation of the agency will be at risk if alternatives are not found. There are currently no extra resources for promotions, and additional programming, which are an essential part of our operations. Our agency works proactively to provide advocacy and role-modelling to youth, empowering them to have control over their destiny, while contributing positively to the community in which Advance Funding Request (pg 2) they live. It is estimated to cost $95,000 per year to incarcerate one individual. Studies done in Washington State in 1998 have indicated that Big Sister/Big Brother and similar prevention programs can be attributed to a 20% decrease in the predicted number of criminal offenses occurring. Through the Ontario Lottery Corporation Advanced Funding Initiative, it is our hope to direct more funding directly to our secondary programs, as well as supporting the future initiatives as outlined at the Strategic Planning session. Big Sisters currently serves 14 Big Sisters and 13 Little Sisters in the Bowmanville area, 11 Big Sisters and 8 Little Sisters in the Courtice area, and 2 Big Sisters and 6 Little Sisters in the Newcastle area. We currently have 12 active volunteers in Bowmanville, 8 in Courtice, and 4 in Newcastle. At this time I would like to thank you for your consideration of our request. Attached please find additional information about our agency, as well as our 1997 audited statements and our to-date unaudited 1998 statements. Should you require any further information, or wish to make an onsite visit to our office, we would be happy to welcome you. Thanking you, ^� J anne Howsam xecutive Director Big Sisters Oshawa-Whitby-Clarington Addendums 1. Big Sisters(What, Why and How) 2. 1997 Financial statements 3. 1998 Unaudited statements to August 1998 4. Revenue Graph 5. List of Board of Directors 6. Initiative#1 7. Charity Registration from Revenue Canada 8. Letters Patent, Bylaws f APPLICATION #20 t .7 • • a • f � a.wwrN.nrs..w - farNMlnYMRNI'9�bN 70fosierilaw-Suke6W Please see attached page of Instructions. Sauk Ste Marie.Ontario PGA 6V2 - Please print or type - 1. Previous charitable gaming licence FOR OFFICE ONLY: Has your organization ever applied for a charitable gaming event licence? F-INo ®Yes (If yes) What is the most recent licence number issued by. AGCO: Municipality. Have you had gaming event licences cancelled or licensing glNo Yes Privileges suspended In any Juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name Canadian Cystic Fibrosis Foundation - Durham Region Chapte C C H 0 4 6 4 Street address of organization City Province 181 Fallin brook Street Whitb a, Postal Cade Telephone No. Fax No. L11 R 2 B 1 {9 0 5 ) 6 66 _ 1 5 7 9 9 0 5 ) 6 6 6 _ l0f2, 91 1 Mailing address(ifdffmW) Postal Code b) Is your organization incorporated as a non-profit organization? []No ®Yes(lt yes) CD 345806 'ef""dw o" Federal Incorporation number I Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? ❑No ®Yes(It0s) 10684 5100 RR0001 Revenue Canada Rep number I I I I I I I I I I I d) How long has your organization existed? What Is the financial year and of your organization Years 38 Month Day January 131 3. Affiliates Is your organization affiliated with any corporation or organization? ®No Yes Ifyrz List Me legal Narnes(Attach sere shed it rrettssary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Arch separate shed Ilnlx>'ssxyJ Patient services at cystic fibrosis a) clinics b) Clinic grants C) d) Oueftlens? Call 1-800-387-0098 ac CAP 001(ears) Continued on back Y S. Lottery trust account '. - - Name of financial institution where today funds are held Account number ^/),/t,</7- j Address - chy— 6. Unorganized Areas Is your Charitable organization located In an unorganized area? ONO ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED F-� RAINY RIVER UNORGANIZED KENDRA UNORGANIZED F-1 SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED F"� TIMISKAMING UNORGANIZED 7. Decteradon We,the undersigned.declare that: • fAve are a Principal Officer of this organization. • Uwe are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • IMe agree to deposit all advance funding into the designated lottery trust account. • IMe agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • Ail answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Ad [o ama 6 tt l/PI ✓` %� ll l otqso to anaym Providing Inaccurate Information may render your organization Ineligible for advance funding avestioas7 Call 1-800-387-0098 Ce forrmdoife est aussi disponiWe en hanpos. rCanadian Cystic Fibrosis Foundation Fondation canadienne de la fibrose kystique J � a1srRlsunoN ORIGINAL:file or - CC. I)Deouty g 4i PLr m C nt August 31, 1998 eta gr. i k The Municipality of Clarington - 40 Temperance Street s) Bowmanville, ON L1C 3A6 Dear Sir/Madame: This letter is respectfully submitted along with an Advance Funding application form and supporting documents. Please let this letter serve as confirmation that the Durham Region Chapter is a bonafide Chapter of the Canadian Cystic Fibrosis Foundation(Business Number #10684 5100 RR0001; GIN#CCH0464), adhering strictly to its By-laws. Due to the fact that our Chapters cover large geographical areas, The Municipality of Clarington falls in the service area of Durham Region Chapter. In pursuit of our mandate to find a cure or effective control for CF, the Canadian CF Foundation sponsors an extensive array of clinical and research programmes across Canada. Monies from gaming initiatives are dispersed in Ontario from bank accounts managed by the Foundation's Chapters to local cystic fibrosis clinics. Every spring and fall, rigorous competitions are held to determine which programs will be funded, and CF clinics undergo regular reviews by the Foundation. By funding only programmes with demonstrated merit, the Foundation can offer the best prospect for a cure or control for CF patients from across the country, including those from The Municipality of Clarington. The incredible advances in CF research over the past decade are proof that such an approach truly benefits all CF sufferers. Thank you for your assistance in these matters. If you have any questions please do not hesitate to contact Linda Salb at the Canadian Cystic Fibrosis Foundation's national office (1 800 378-2233). Sin rely, NL D ham Region Chapter President encl. Give the breath of life' Fight cystic fibrosis. Donnez le souffle de vie.."°Combattez la fibrose kystique. Charitable Registration N'o.!Numeto d'enreglstrement d'organisation nharitabte 015892-11-1J • ^A � a.ax hs '. ea. APPLICATION $21 70 faster prix Suitie Please see attached page of Instructions. , eSOO 89p P 9 sa6A 5t,2 Mane.Ontario _ please print or type — 1. Previous charitable gaming licence FOR OFFICE USE ONLY: Has your organization ever applied for a charitable gaming event licence? F_�No 7 Yes(Ilyes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any jurfdication in the last two(2)years? No Yes 2. Information on organization GIN a) Incorporated or legal name Canadian Diabetes Association, Durham Region Bnnch Street address of organization City Province 909 Simcce St. N., #2 Oshawa ON Postal Code L I G 4W I Telephone No. (905)436.6648 // Fax No. (905) 725-0216 l Mailing address(it different) Postal Code b) Is your organization incorporated as a non-profit organization? E]No Q Yes(If yes) Jurisdiction of Incorporation number 11883 0744 RR0001 Incorporation Government of Canada c) Is your organization registered as a Charitable Organization with Revenue Canada? Reg.number was converted to BN 11883 0744 RR0001 O No Q Yes (If yes) Revenue Canada Reg.number I I I I I I I I I I I d) How long has your organization existed? What is the financial year end of your organization Month Day Years 4 S`1 c k(L.T August 31 3. Affiliates Is your organization affiliated with any corporation or organization? No ©Yes If yes. List the legal Names(Attach separate sheet if necessary) Our organization is a Bmnch of the Ontario Division of the Canadian Diabetes Association. a) b) 4. Use of net proceeds 3'7Z"j What will the advance funds be used fort(Attach separate sheet ifnecessary) Please see attached sheet. a) b) c) d) Ouestidns? Call 1-800.387-0098 o,c caa ear(98105) Continued on bock 1 5. Lottery trust account - Name of financial institution where lottery funds are held Account number Royal Bank of Canada 107-185-1 Address city 1050 Simcoe Sc. Oshawa, ON 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No Yes(it yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned. declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • 1/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature �4 Susan Koster Nnt name In lull Ted Savelle President Title Branch Coordinator I I (416) 2918-5141 I I Business telephone number / I I I (905)436-6648 I I �/�2 rl Date Signing ` Providing inaccurate information may render your organization ineligible for advance funding Uuesfions? Call 1-800-387-0098 Ce formuioire esf aussi disponible en tranpas CANADIAN I ASSOCIATION DIABETES CANADIENNE ASSOCIATION DU DIABETE October 28, 1998 Marie P. Knight The Municipality of Clarington 40 Temperance St. Bowmanville,Ont. L1C 3A6 Re: Advance Funding Application Dear Marie P. Knight Please find attached our application to participate in the advance funding program. We have heard that the provincial government will be giving money to each Ontario municipality,to allocate to charities that provide services to local residents. Approximately 3600 people in Clarington have diabetes, a disease which can lead to complications such as heart attacks,blindness and kidney failure. The number afflicted will grow over time, as one in four baby boomers is expected to develop diabetes. In the hope that a cure is soon found for this disease, the Canadian Diabetes Association funds diabetes research. Until we find a cure,we will continue working to educate the public about diabetes and to provide services that improve the quality of life for people affected by diabetes in Clarington. We have enclosed an outline of the services we provide in Clarington. The costs mentioned in this outline are supported by the financial statements and budgets provided. Please note: as we have just recently begun our 1999 fiscal year, our fiscal 1999 operating budget has not yet been finalized. We have attached our most recent draft of this document. Please call us if you have any questions or require more information. We appreciate your consideration of our application. Thank you for your support in the fight against diabetes. Sincerely, Susan Koster President. Canadian Diabetes Association. Durham Region Branch Durham Region Branch 909 Simcoe Street North#2 Oshawa, Ontario L1G 4W1 Charitable Registration#1060754-I1-13 (905) 436-6648 Fax (905) 725-0216 CANADIAN ASSOCIATION DIABETES CANADIENNE ASSOCIATION DU DIABETE December 1, 1998 To: The Municipality of Clarington Attn: Clerk's Department-Advance Funding From: The Canadian Diabetes Association Per your request, I have enclosed a cheque for the advance funding review and a list of our Executive Committee. Additionally, I have reworked some numbers concerning the funding request and have come to a figure that is far less than the original submission. I would ask therefore, that this new submission be reviewed rather than the previously submitted request. Thank you for your attention to this request. Sincerely, ,. / d Ted Savelle Branch Coordinator cc: S. Koster, President Durham Region Branch 909 Simcoe Street North #2 Oshawa, Ontario L1G 4W1 Charitable Registration# 1060754-I1-13 (905) 436-6648 Fax(905) 725-0216 CANADIAN DIABETES ASSOCIATION,DURHAM REGION BRANCH OUTLINE OF CHARITABLE SERVICES PROVIDED TO The Municipalitiy of Clarington More than five percent of Canadians have diabetes, a disease which can lead to complications like heart attacks, blindness, nerve damage and kidney failure. There are approximately 3600 people with diabetes living in Clarington right now.. and everyone in Clarington is likely to know someone with the disease. Our diabetes awareness and education services benefit everyone in the community.Education about diabetes prevention and about avoiding the complications of diabetes can change the quality of life for a great many people,and can result in substantial savings for our healthcare system. Research shows that most people with diabetes,even today,do not receive adequate self-care education.Until we find a cure for diabetes, our organization will be working to educate people in Clarington who are affected by it. All costs listed in the information that follows are supported by the figures on the organization's current operating budget,attached. The total annual cost for the Durham Region Branch of the Canadian Diabetes Association to provide its services to the public is $111,916. Our Branch is in a rebuilding phase that we began in earnest at our Annual Meeting in May 1998. Prior to this, for a period of two years,we were only able to provide maintenance service in our area. With our newly elected Executive we are now stepping into the community with specific goals and objectives that will provide better service and awareness about the effects of diabetes in Clarington. SERVICE DETAILS: 1. INFORMATION MEETINGS The public are invited to attend our information sessions on diabetes, its prevention and its treatment. On November 24 our meeting will be held in Whitby with a local chiropractor and chiropodist giving information about their areas of expertise and its relation to diabetes. Two further sessions are to be held in the coming winter and spring. We provide displays at public health forums, expositions and health fairs. This coming year will see us expand this activity to be proactive in seeking new locations as opposed to responding to requests. We provide speakers to organizations and local companies to encourage a greater awareness of diabetes. Deliberate focus is being given to corporate and employee group presentations in the coming year. In the summer of 1998 we held two presentation sessions at Darlington Nuclear Plant for their maintenance workers as well as Pickering Nuclear Station. 2. REFERRAL SERVICES • In conjunction with Diabetes Education in our Region,we are developing an information brochure for distribution to medical facilities practitioners, and health care providers. At the same time, we are developing a general brochure for public distribution throughout Clarington. • People from Clarington regularly come to our office located in Oshawa to gather more information about our services and to pick up brochures and cook books available to the public. 3. SUPPORT GROUPS • We provide monthly diabetes information services at the Whitby Seniors Centre and in Port Perry for support groups participants. Our goal this year is to establish groups in Clarington. Ideally, we will be contacting our membership in Clarington and conducting a survey to determine needs in a support group system. We know from our experience in Port Perry and Whitby that this group interaction is an excellent vehicle to keep up dated on diabetes. q. NEWSLETTER& DIABETES DIALOGUE • The members of the Canadian Diabetes Association in Clarington receive a quarterly newsletter from our local Branch -Diabetes Digest. The newsletter includes information about diabetes and diabetes management. details about the programs run by our Association and notification of upcoming local diabetes related events. • Four times per year. Association members also receive a copy of the national magazine, Diabetes Dialogue. 5. MEMBERSHIP SERVICES • Part of our ongoing services to our members will be yearly surveys to ensure that our activities meet the needs and requirements of our members. • On a yearly basis, we provide our membership with items that can be used as household tools- rulers, refrigerator magnets to name a few. These items contain specific information statements about CDA-address, phone etc. As a point of impact tool, it has been invaluable in reference back to the Branch. 6. BLOOD GLUCOSE MONITOR TRAINING: • With the continuing use of diabetes in our population. many individuals are not aware of the correct procedure to measure their blood sugar levels on a regular basis. To activate this service, we require the specialization of trained volunteers/staff who have the knowledge and ability to give accurate assessment of the reading and the appropriate action for the client to take. i CANADIAN DIABETES ASSOCIATION,DURHAM REGION BRANCH ADVANCE FUNDING APPLICATION- ITEM#4,PROPOSED USE OF NET PROCEEDS Any funds allocated to our organization will be used to provide diabetes education, awareness and services to the community, as described in the attached outline. The services that would be funded include brochure publication for membership, general public and the medical profession, membership drive. support group development, education sessions at local hospitals, information evenings, special event development,expanded volunteer recruitment. We have received feedback from the community that suggests a great need for additional services that we do not yet have the resources to provide. With sufficient funds, we could carry out the following new projects: 1. INFORMATION MEETINGS • With an emphasis being placed on more information evenings, additional displays for education, and development of speakers,we anticipate that this will cost$300. 2. REFERRAL SERVICES: • A newly diagnosed individual has a variety of urgent needs that must be addressed. These include psychological concerns, a diabetes management regimen and control systems that are dealt with by the physician and a diabetes educator. Beyond these initial, sometimes fearful, reactions comes the new feeling of ownership and control of the disease. In this situation, people come to CDA for additional information about diet and diabetes management. At present we have a selection of specific diabetes cook books that can help an individual to better provide themselves with adequate nutrition and maintain the correct nutritional intake. • We propose that if we could provide the cook books free of charge to newly diagnosed members, we may be able to give them an early reactive measure to assuage their concerns. • We anticipate that,with our proactive membership drive for 99/2000, the costs for this service will be $720 in Clarington. 3. SUPPORT GROUP SESSIONS: As we become an increasing source of reference and referral, the public has requested that we become more local in our approach in offering support. To this end, it is envisioned that we should and must provide opportunity for persons with diabetes to meet and exchange concerns, ideas and to share knowledge. In consideration of the manpower, technology and demands of this new service, we suggest that$200 is needed to initiate this activity. 3. NEWSLETTER AND DIABETES DIALOGUE: • At present our newsletter (two publications in the past 3 years) is dependent on budget constraints and sponsor cooperation. With the new and emerging information from the scientific community as well as our own local development, we believe that we must promote the newsletter service bi- monthly. This will require expanded funds to produce this product. We propose that $100 in advance funding will cover production and making costs for this information service. 5. MEMBERSHIP SERVICES- LOW VISION DIABETES ASSISTANCE: • One of the complications of diabetes is blindness. In fact diabetes is the leading cause of adult blindness. As a result of this, many people with diabetes with low vision impairment require blood monitoring devices that have the capacity to give a verbal read out as opposed to a standard digital read out. We propose that the Canadian Diabetes Association is prepared to assume a portion of the cost if these monitors equal to the difference between a standard model and one that requires voice. Clearly there is a need for medical parameters required to implement this type of service. CDA will work with appropriate authorities to authenticate the diagnosis. We suggest that this type of service can be initiated with funding in the amount of$300. 6. SUMMER CAMP FOR CHILDREN WITH DIABETES: • Each year, our organization helps families in the community cover the cost of sending their children with diabetes to Camp Huronda. At camp, children can learn about managing their diabetes in a fun and safe environment. Parents benefit from the knowledge that health professionals are always on hand. Many children with diabetes first learn to assume responsibility for their own daily insulin injections while at Camp Huronda. • The cost to send a child to camp is $250. It is anticipated that as more and more children are diagnosed with diabetes,we will probably receive more requests for assistance. 7. BLOOD GLUCOSE MONITOR TRAINING: • With the continuing use of diabetes in our population, many individuals are not aware of the correct procedure to measure their blood sugar levels on a regular basis. To activate this service, we require the specialization of trained volunteers/staff who have the knowledge and ability to give accurate assessment of the reading and the appropriate action for the client to take. • To effectively promote and administer this service will require a minimum of$500. This will include training sessions for volunteers, recruitment advertising,transportation and material. TOTAL COST OF SERVICES REQUIRED BY THE CANADIAN DIABETES ASSOCIATION INFORMATION MEETINGS: 5300 REFERRAL SERVICE $720 SUPPORT GROUP SESSIONS: 5200 NEWSLETTER: 5100 MEMBERSHIP SERVICES: 5300 SUMMER CAMP: $250 GLUCOSE MONITORING: S500 TOTAL: $y APPLICATION 122 g o.mr,.mnr.,a.w. 19.7 Please see attached page of instructions. ?O Foster Drive,Suite 800 P g Sawn Ste.Mane.Ontario ?6A 614 - Please print or type - 1. Previous charitable gaming licence FOR OFFICE USE ONLY: Has your organization ever applied for a charitable gaming event licence? ®No ❑Yes (If yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any jundication in the last two(2)years? ®No Yes I Z Information on organization GIN a) Incorporated or legal name CATHOLIC FAMILY SERVICES OF DURHAM ^-^R 1 ^^7 --^I Street address of organization City Province I 670 Ring Street East Oshawa Ontario Postal Code Telephone No fax No Lit IHILIG15 (91015712151 _ 13151113 91015 71215 _ 18131717 Mailing address(if diflerent) Postal Cade b) Is your organization incorporated as a non-profit organization? ❑No ®Yes fft yesj Jurisdiction of Incorporation number 545027 Incorporation Ontario c) Is your organization registered as a Charitable Organization with Revenue Canada? No ®Yes(11 yes) I Revenue Canada Reg.number 1 10 1 6 1 8 1 810 1 0 1 5 1 7 1RRI OOPI d) How long has your organization existed? May 30, 1983 What is the financial year end of your organization Month Day Years 15 12 31 3. Affiliates Is your organization affiliated with any corporation or organization? 7 No ®Yes ll yes: List the legal Names(Attach separate sheet if necessary) Please see attached a) b) 4. Use of net proceeds What will the advance funds be used for? (Attach separate sheet if necessary) Requested amount $3D,000.00 a)Parenting Programs d Parent Support b) Sexual Abuse Recovery Group Program for Teen Girls (13-16 yrs) ,) Family Counselling Crisis Counselling for Abused Women Ouestions? Call 1-800-387-0098 o,c wool (eams) Continuec on cock I 5. Lottery trust account Name of financial institution where lottery funds are held Account number Bank of Montreal 8077-421 Address East Mall Shopping in Centre City 600 Ring Street East Oshawa L1H 1G5 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No ❑Yes(If yes,p/ease indicate) ❑ ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned. declare that. • Ilwe are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance fundino • I/we have been authorized to make this application on behalf of the organization. • Uwe agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved chantaole purposes only. • ifwe fffieJ � Not required as per enquiry to Ontario Lo Corporatio • All answers provided in this Application. as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer & w _ y.tPrWt:namslia>ta Patricia Grant P1 J. Drew Brown nT1B r ,3. Executive Director Chairperson, Board of Directors BiYtiaessleleph�ttsnlumber> 9 1 01 5) 712 1 51 — 13 1 511 1 3 -r 4 1 11 6) 816 1 61 — 15 1 71 214 0, 11ppfllp ` October 23_ 1999tu October 23 1998 Providing inaccurate information may render your organization ineligible for advance funding Ouerfions? Call 1-800-387-0098 Ce formwove esr oussi osocnible en fron;os Catholic Family Services Of Durham MAIN OFFICE. 670 KING STREET EAST, OSHAWA, ONTARIO 5 7 27 905-725-3513 50 COMMERCIAL AVENUE, SUITE 205.. AJAX, ONTARIO LIS 2H5 / 905-686-4350 �cy ��� FAX: (905) 725.8377 Nov. 27, 1998 Corporation of The Municipality of Clarington 40 Temperance St. Bowmanville, Ont. L1C 3A6 Dear Sir or Madam: Enclosed is an application for advance lottery funding in the amount of $20,000 to assist Catholic Family Services of Durham to provide services to residents of Clarington in 1999. Our agency provides individual, couple and family counselling, family life education programs and specialized counselling programs for victims of violence i.e. primarily abused women and children. Last year 23% of our total clientele were residents of Claringtron (736 individuals). Our Oshawa office is located at 670 King Street East, close to Harmony Road; residents of Clarington do find our service accessible. Our services are available to anyone who resides in the region regardless of their religious background or their ability to pay. I have enclosed brochures as well as our audit for 1997. Please be advised that our reserve fund for building and equipment is for a projected move to an expanded office location in Oshawa. The monies are fundraising dollars raised to assist with leasehold improvements and equipment. We are presently searching out a suitable and affordable location. We plan to continue to be accessible to Clarington residents. Please contact me at 725-3513 if you have an questions about our application. Yours truly, Patricia Grant, I.13N.M., M.S.W., C.S.W. Executive Director A Member Agency of Catholic Charities 9 A Member Agency of Family Service Ontario • A United Way Member Agency 1 APPLICATION 123 OIhrN LJOfIy Co-pantlaf SJti11//111011llef 41'OebRJ 70 Foster drim S0e Ed Please see attached page of Instructions. sa tt sre.bland,Ontario PV 6V2 - Please print or type - 1. Previous charitable gaming licence_. FOR�qFfl.CE USE ONLY. Has your organization ever applied for a charitable gaming event licence? OX No F-]Yes(lr'yes) What is the most recent licence number issued by: AGCO: .P Municipality: M Have you had gaming event licences cancelled or licensing ❑No E]Yes privileges suspended In any juridication in the last two (2)years? 2. Information on organization - GIN a) Incorporated or legal name Durham Region Community Care Association Street address of organization City Province 419 King Street West Suite 605 Oshawa Ontario Postal Cade Telephone No. Fax No. Li 1i I ( 9 10 1 5 ) 4 1 04 1 — 1 22 1 24 9 1 054 10 1 4 1 2 12 4 11 Mailing address(if di!lerent) - I Postal Code - I I ( 1 1 - b) Is your organization incorporated as a non-profit organization? ❑No ❑Yes(1 1yes) Jdiction of Incorporation number 520432 Incorurisporation Ontario c) Is your organization registered as a Charitable Organization with Revenue Canada? E]No XQ Yes(1 1yes) Revenue Canada Reg number 1 11 18 18 1 8 1 91 91 51 RI R10001 d) How long has your organization existed? What is the financial year end of your organization Month Day Years 21 years I March I 31 3. Affiliates Is your organization affiliated with any corporation or organization? ©No D Yes It yes: List the legal Names(Attach separate sheet it necessary) a) b) nn 4. Use of net proceeds ►7 M�1�1�'r �EQ011cST p f ( t X00. What will the advance funds be used for?(Altach separate sheaf if necessary) (See attached) a) b) c) d) Questions? Call 1-800-3117-0098 oLC Cv 00 i(earas) Continued on back 1 5. Lottery trust account Name of financial institution where lottery funds are held Account number Toronto Dominion Bank To be arranged Address city 4 King Street West & Simcoe Street Oshawa 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No 7 Yes(if yes,please indicate) ALGOMA UNORGANIZED F-� PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED KENDRA UNORGANIZED E] SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer �Printnama In Elizabeth Fulford - Eleanor Ireland FxPrnr;ve DirP�tor ;; �° > ' Director Finance & Administration Business telephpne ; 910 15 ) 410141 — 1 2121 21 4 number (9 10 15 4 101 41 _ 12 1214 November 24 1998a �`* November 24 1998 Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponVeen fronpois. DURHAM REGION COMMUNITY CARE ASSOCIATION CLARINGTON COMMUNITY CARE ADVANCED FUNDING REQUEST Communications - Internet $1,000.00 Year 2000 Compliance 5,000.00 Additional Computer Stations (2) 8,000.00 TOTAL REQUEST FOR ADVANCED FUNDING $14,000.00 APPLICATION #24 abrar.mn.t.osau.. . Please see attached page of instructions. rdraaerOrn,Sureaw P 9 saul(sta Marie.Ontario P64bvr - Please print or type - 1. Previous charitable gaming licence FOR OFFIC E USE ONLY: Has your organization ever applied for a charitable gaming event licence? ❑No 7X Yes(11 yes) What is the most recent licence number issued by: AGCO: P Municipality: M 428321 Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? FL]No Yes 2. Information on organization GIN a) Incorporated or legal name Grandview Children' s' Foundation G R C I 2 1 1 9 Street address of organization city I Province - 600 Townline Road South Oshawa Ontario Postal Code Telephone No. Fax No. L 1 11 H 17 IK 1 6 (9 10 15 ) 7 12 18 _ 11 6 1 7 1 3 91 01 5 ) 7 2 8 _ 2 1 91 61 1 Mailing address(i7 different) - ..I 'I—Postal.Coder I 1 ) I I b) Is your organization incorporated as a non-profit organization? E]No X❑Yes(11 yes) Jurisdiction of Incorporation number 1139492 Incorporation Ontario, Canada c) Is your organization registered as a Charitable Organization with Revenue Canada? ❑No ©Yes (11 yes) I Revenue Canada Reg.number 8 19 11 I 0 15 18 l 5 14 17 l R l R 10 0 0 d) How long has your organization existed? What is the financial year end of your organization Years 3 years Month Day March 31 3. .Affiliates -- —+-----Is your organization affiliated with any corporation or organization? [X]No E]Yes 11 yes. List the legal Names(Attach separate sheet it necessary) a) b) 4. Use of net proceeds }n-� ! � What will the advance funds be used for?(Attach separate sheet itnecessary m O0 o) 1 ` SEE ATTACHMENT a) b) C) d) Questions? Call 1-800-387-009 orC GP 00 c9a05> Continued on bock S. Lottery trust account Name of fiinancial Institution whem lattery tunds are held' - - 1 number ` � -• ...-ew.._nwwf4•Vr.w.:N R\�Cn.. ' .en,•.. ♦ .- .l Royal Bank of Canada 100-001-7 Address 1405 King Street East ctry Courtice , Ontario i. Unorganized Areas Is your Charitable organization located in an unorganized area? X❑No []yes(tt ylM pimse indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED Declaration We. the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • Itwe agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. ]/we will sponsor table game events at the local charity casino. • All answers provided in this Application. as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Princ' 1 O 1 er Principal Officer �r r 4 Signature- D ld Whitbread Prinlpameln1u11+'x Charles J. Ryan Chair, Board of Directors Vice Chair, Board of Directors 's. 3 1 01 5 5 17 11 I _ IO 15 11 IS Basinesstelephonenumber= 10 1 5 ) 61 41 41 _ 1 71 41 41 6 le SlgnnT. a t Providing inaccurate information may render your organization ineligible for advance funding eslions? Call 1-800-387-0098 Ce(Ormulaire est oussi disponibfe en Iranpals. Attachment 4. Use of Net Proceeds Proceeds would be used by Grandview Children's Centre to provide services to children in Durham Region with physical disabilities and communication disorders. In the year ending March 31, 1998 2,614 children from Durham Region were treated at Grandview. The main facility is located in Oshawa and there are satellite offices in Port Perry to provide services to the children and their families in North Durham. The other office is in Ajax and treats children living in West Durham. Over the past year, Grandview's physiotherapists, occupational therapists and speech pathologists provided treatment for approximately 450 children and their families residing in the Municipality of Clarington. x yr November 6, 1998 Marie P. Knight GRANDVIEW Deputy Clerk C H I L D R E N ' S Corporation of the Municipality of Clarington CENTRE 40 Temperance Street _ 05h anOnunoLIH7K6 Bowmanville, Ontario L1 3A6 Oshawa t 905 28 173 1-- Telephone 905�12A-16]3 � Fu W3-72X 2961 Dear Ms. Knight, ; is Re: Application for Advanced Funding r We are pleased to provide the additional information you requested regarding our application for advanced funding. 1. We are requesting $35,000. The funds would be used to supplement the annual operating budget of the Centre which has had its funding frozen since 1993. We find it is necessary to use this money for operations, as the high growth in Durham Region of young families combined with an extremely lengthy funding freeze has put tremendous strain on the Centre's ability to provide health care services to the Region's special needs children. 2. Grandview Children's Centre has benefited the Municipality of Clarington since 1954 by providing a range of health care services and supports to children and young adults with physical and communication disabilities living in Durham Region. Last year, over 450 children and their families living in the Municipality of Clarington received services at Grandview. These services included: audiology; speech language pathology; occupational therapy; social work; and physiotherapy. Specialized services include a Seating Clinic, Orthopaedic Clinic, Orthotics Clinic and a unique community-based Preschool Outreach Program. The programs offered at Grandview are designed to support the child and family in.. achieving an optimum !evel of independence in .heir home and their community. ._ .. .... ....... If you should require any additional information, please do not hesitate to contact ' me. Yours truly, Linda Watson - Executive Director Grandview Rehabilitation&Treatment Centre of Durham Region - - A Registered Charitable Organisation - - - CHARITY ROSTER APPLICATION APPLICADVANCE FUNDINC ATION #25 rurrrrrr , 7or0r9aasaftaao Please see attached page of Instructions. safrsrt ark a aw NAM - Please print or typo - 1. Pravlow ehuttaubls garning Iksnr:a Has your organiabon ever applied for a charitable gaming event Ikence? ©No ❑Yea(f yas) What Is the most recent license number blood by: ABCI): Munidpakly: Nave you had gaming event Nronea CoMed or Nlxroing privileges suspended in any hnldicatfon in the last two(2)years? ©N° ❑Ya 2. IMormetion on orgenlaation OIN a) Incorporated or legal nrae Kawartha Child Care Services start address of wpanlaeon Gb Prorauce 201 Antrim Street (Head Office) Peterborough ON Paw Code Tabplrorra No fat W .. Mdrg addrrass Ndelrsd) PoWI Cade b) Is Your aganfndon bwrporand as a non-pmM wpaMaerq? C]No ®�(nl'g1 _Incorporation number 498551 Incorpowon Ontario Q Is your apant lbon regbto ev a a lonstb orpNdallon wah Ravenss Canaft? ❑No ©Yes(l'las) Name Canada PAM raanb�r I O 1 7 17 15 1 8 12 1 5 1 10 ill d) How long has your aga gatben awlped? Who b Ma Mandel year and d your urrgr I 'm N9odb Day Yws 17 March I 31 ?v AMIgaAse Is your oMeniation aMUM wth any carperden or orprNntlon? ®No . . ❑Ye sny er tnr#WkWAbw(AMdraewraMshernneaaury) a) b) 4. Use or net procssde WhO wl the advance funds be used for?(ANadr wpm*&Wifwalseay) a) Toys & Equipment b) Professional Development c)_Program Maintenance d) _ RPnai YC Osesffess7 Call -mm-387 0098 ac ow coy peas Conflnued On bC S. Loetry tnsse.es Dune harrw of ft vcW baebNOn MUMS lottery funds are held — Aoeoum number Toronto-Dominion Bank Address George Street qb Peterborough 6. Warpardn d AraN Is yme 11wftbla DfPnWft leafed in an unorgu*ed am? ID No ❑Yea(ffm ofane isdi*) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED 0 RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. DaolaraUon We.the undersigned.declare that: • IAxe are a Principal Officer ol this organlz". • IA"are NOT receiving remuneration dlr"or Ind eemy horn the advance funding. • IAw have been wftriwd to mdse this applbttion on behait of the organIza m. • Uwe agree to deposit d advance hsrdkrp into the dadgneled lottery host se=am. • IA"Was t0 use the advance funding for approved dwil able purposes only. • Uwe wRl sponsor I"game events at the bcal cherlty casino. • All answers provided in this AppRcaUon,as wee as as the ink rmetbn contained M the documents and materials submitted with R are true and complete, We haw read and urrdarafarrd On with Declaralbn above Prindaal onim PAnedrW eMln.. s ,�> _ 1� ' �'+t5.bt � J net M. Castle „ v Ada Dettenkof -Leah Executive Director ' President 71015) 714191 - 13141818 -�71pt5 6 t5t2l _ 10 r305 Providing inaccurate Information"my render You►organisation Ind11011s for advance%ndbg Oaesfisas7 Call t-800-387-0095 Ce b rKAbNe est Oussi dtsportibfe on ftwK=. Child Car ADMINISTRATION 201 Antrim Street �. Peterborough, Ontario rp l` ;\ K9H 3G5 Y to Phone (705) 749-348$ Fax(705) 749-9788 02 November 1998 Municipality of Clarington Clerk's Department 40 Temperance Bowmanville, ON L1C 3A6 Please find enclosed our application for funds through the Ontario Lottery Corporation Advance Funding Initiative. This application is intended to support our Child Care Centre operating in Courtice. We have been operating this centre for 7 years. We request$5,000.00 to update our toys and equipment and build a shade structure for our playground. Our attachments have been numbered as follows; • Application #1 • Governing Documents #2 • Revenue Cananda Notification #3 • Detailed outline of Programs #4 • Operating budgets currentAast period #5 • Financial Statements #6 • List of Board of Directors #7 If you have any questions about our organization please call. Sincerely, anet M. Castle Executive Director Today's Children, Tomorrow's Fadere APPLICATION 126 CHARITY ROSTER APPILMA�TION �DVANII�E FUNDING < ' : o.mtet.ron uvpun Suifea 70 fasterpme. a'w dd terO Please see attached page of Instructions. SaultSte.Marie.drxario — Please print or P6A612 P type - DURHAM 1. Previous charitable gaming licence • ' • • H your organization ever applied for a charitable gaming event licence? Has ❑Yes(Ifyes) What is the most recent licence number issued by: AGCO: P Municipality: M ' Have you had gaming event licences cancelled or licensing ®No ❑Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN. a) Incorporated or legal name _ Kinark Child and Family Services Street address of organization City Province 240 Duncan Mill Road Suite 402 Don Mills ON Postal Code Telephone No. Fax No. 3 I BI 31 B 1 2 ( 4 1 11 6 ) 3 1 91 1 1 _ 1 3 1 81 8 1 4 ( 4 Ill 6) 41 4141 - 1818 9 6 Mailing address(if dillerent) Postal Code b) Is your organization incorporated as a non-profit organization? ❑No ®Yes(It yes) Jurisdiction of Incorporation number 264585 I Incorporation Province of Ontario c) Is your organization registered as a Charitable Organization with Revenue Canada? ❑No ®Yes(It yes) I Revenue Canada Reg.number 1181 9 1 8 1 1 1 1 1 21 51 R I RI 0 1 0 1 O 1 d) How long has your organization existed? What is the financial year end of your organization Month Day Years Twenty-Five I March I 31 3. Affiliates Is your organization affiliated with any corporation or organization? Q No ❑Yes It yes: List the legal Names(Attach separate sheet if necessary) a) b) 4. Use of net proceeds rP 9 What will the advance funds be used for?(Attach separate sheet if necessary) a) PLEASE SEE ATTACHED FORM b) C) d) Quesfions7 Call 1-800-387-0098 oLc CAP am t9aM5) Continued on back 5. Lottery trust account __ Name of financial institution where lottery funds are held Account number _ THE TORONTO DOMINION BANK 0403 0602335 Address City King Park Plaza, 245 King Street West OSHAWA 6. Unorganized Areas Is your Charitable organization located in an unorganized area? 0 No ❑Yes(11 yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Kdt N Neville Jones § Rlnnatnsiniullk Jane Dawes Director, Finance �' xsjge= �„ Director, Human Resources 411 1 6 � 31 9 1 — 3 8 8 1 4 osinettleiepbonan, ar ._� 4 1 11 6) 31 9 1 11 — 1 3 1 81 8 1 4 October 26, 1998 �; Date"SipnlgQ art, October 26, 1998 Providing inaccurate information may render your organization ineligible for advance funding QuestlonV Call 1-800-387-0098 Ce formulaire est oussi disponible en hangois. KINABK Child Child and Family Services and 240 Duncan Mill Road Family suite 402 Services Don Mills,Ontario M3B 3132 Telephone)416) 391-3884 ADVANCE FUNDING APPLICATION SECTION #4 - USE OF NET PROCEEDS DURHAM REGION Kinark Child and Family Services is one of the largest non-profit children's mental health centres in Ontario, operating across six areas of the province. Our mission is to strengthen the social, emotional and behavioural well-being of children and their families. Last year in the Durham region we served more than 750 families. We offer a wide range of counselling, classroom, residential and psychological services as well as having a strong volunteer program. Durham Region is one of the fastest growing areas in Canada with many new immigrants settling daily in the region. Kinark has recognized the value in reaching out to those families. To this end we have initiated a diversity program that is designed to network within our community to encourage families from diverse cultures to utilize children's mental health services as needed. In the spring of 1999 we are planning a weekend program for families who are dealing with issues of racial or cultural discord. Specifically we will be targeting high risk parents and children who are socio-economically challenged. The Parenting in Canada project will take place at the Kinark Outdoor Centre, just outside Minden with approximately 16 families attending. The weekend program will include workshops and panel discussions for parents and children. Several speakers will address issues around teenage pregnancy, street crime, street drugs, spiritualism and the Canadian educational system. This weekend will be provided at no-cost to the families. Kinark's cost to provide this event will be $11,119. The budget is broken down as follows: Camp Costs ($368 per family X 16 families) $ 5,888 Transportation $ 731 Speaker Honoraria $ 2,500 Pre-Weekend Support/Materials/Supplies $ 2,000 TOTAL COST $11,119 Income Tax Donation Registration#0409821-11-13 KINAQK Child Child and Family Services and 240 Duncan Mill Road Family Suite 402 Services Don Mills,Ontario M38 382 Telephone (416)391-3884 November 25, 1998 Marie P. Knight Deputy Clerk The Municipality of Clarington 40 Temperance Street Bowmanville, ON L1C 3A6 Dear Ms. Knight: As requested in your letter of November 6, 1998, 1 have attached a $25.00 processing fee to accompany our application for advanced funding. As well, I have attached a short explanation on how Kinark benefits residents of Clarington. As well, in your letter you were looking for confirmation of the amount that we were requesting. The total amount of our project is $11,119, however, we would be thrilled to receive any amount of money towards this cause. Please do not hesitate to call me if you require further clarification. My phone number at Kinark is 416-391-3884 x310. Regards, Sara Lanthier Executive Assistant Income Tax Donation Registration#0409821-11-13 Established in 1984, Kinark Child and Family Services is a one of the largest non-profit Children's Mental Health Centres in Ontario. Kinark operates in five regions across the province including the Durham region. Kinark is a fully accredited member of the Ontario Association of Children's Mental Health Centres. Our mission is: To strengthen the social, emotional and behavioural well-being of children and their families. We seek to achieve this goal by being a provider of choice in the delivery of the highest quality services to our clients in partnership with community resources. Kinark is governed by a volunteer Board of Director with representation from each of the program areas in which we operate. The members of the Board come from a variety of professions and occupations bringing a range of skills to Kinark. The board encourages representation from former clients and parents to ensure the agency has access to and/or knowledge of the consumer's perspective. Additionally, in each of its program areas, a Parent or Consumer Advisory Committee is in place which meets regularly to discuss issues, identify service needs and gaps and make recommendations to management teams on how Kinark might better serve the local community Kinark provides a broad range of services to families in Durham Region. The Durham Program offers services for children up to the age of 12 and their families. The exception to the age requirement is our Families First program that provides services for children up to the age of 18. We have available a multi-disciplinary team that includes social workers, child and youth workers, psychology staff, psychiatric consultants and nursing staff to assist in providing the most effective services possible. We also aim to deliver services in ways that are sensitive and show respect for each family's cultural, racial, religious and language diversity. Since April 1, 1997 the Kinark Durham Program has served 75 clients from the municipality of Clarington. APPLICATION #27 OnlMb/bR41'rIXlp/bb/ SOdfN/H INMH H I'O�htlb 70 FOSrer Ohre.Swe eOO Please see attached page of instructions. IzA Ste.Marie.Onraoo P54 eV1 - please print or type - I. Previous charitable gaming licence Has your organizatip ever applied for a charitable gaming event licence? No Yes(,,yes) - - � IS What is the most recent licence number issued by: AGCO: _ P Municipality: M Have you had gaming event licences cancelled or licensing o Yes privileges suspended in any juridication in the last two(2)years? V� 2. Information on organization GIN a) Incorporated or legal name LL F�4�<7t I� '+��-iGVI Cz%�tr�C�c�'fiiGi�'"fL4'•-f-I-e �lk�--h Y'Q c? i Z k --( M Of 51 1 Z anization City P Qvince E Postal Code Telephone No. Fax Lt 1 Yms V - (2,cis ) TI Sl f — I I SIC c 91 15) 71 �3k I — Ia VI W Mailing address(if different) Postal Code I b) Is your organization incorporated as a non-profit organization? 014o Yes(it yes) Z 9 �r /1 Jurisdiction of y/� Incorporation number T �-. I Incorporation a L-i`wl c) Is your organization registered as a Charitable Organization with Revenue Canada? No (It yes) Revenue Canada Reg number � 419l` 191 J 1 1 1 1 d) How long has your organization existed? What is the financial year end of your organization Month Day Years y� � I :a,) 3. Affiliates 1 Is your organization affiliated with any corporation or organization? No Yes it yes: List the legal Names(Attach separate sheet if necessary) i (a-4e qs S�:) ll� lam �fJ�i s C�Sa�� 'r.C-,l c f jD'K,v-i a1 QVe&h'Id 4. Use of net proceeds Q t� What will the advance funds be used for?(Attach separate sheet if necessary) a) � �f, ��T � 1 kc r I ��.b) c) dl Ouestiens? Call 1-800-387-009b OLC wool (9e05) Connnuea on bac: 5. Lottery trust account Fume of financial institution where lottery funds are neld Account number Address r f < < I City C+ 6. Unorganized Areas 7 No Chantahle organization located in an unorganized area? Yes(l(yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned. declare that: • l/we are a Principal Officer of this organization. • [/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization- • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Princi Pat Officer Principal Officer dda cStpnature Print name in fall — fT' DIRECTOR OF REGIONAL OPERATIONS 1 nue ( / I /IV ) ���I�(/G Busiaesstelephaneaum6er ! t, � y Oate Sipntnpr;. Providing inaccurate information may render your organization ineligible for advance funding ouestion Call t-800-387-0098 Ce formufatre esr ausst arsponioie en frOnGo,s Honorary Patron/Presidente d'honneur W31 ONTARIO LA MARCHE The Honourable Hilary M.Wesson, MARCH DES DIX SOUS Lieutenant Governor of Ontario September 23, 1998 \ A OF DIMES DE UONTARIO L'honorable Hilary M.Weston, Independence for Adults with Physical Disabilities lieuten ante-gouverneure de('Ontario Autonomie pour adultes ayant un handicap physique Municipality of Clarington Patrons/Comitede patronage Lottery Licencing Department 40 Temperance Street The Honourable Lincoln M.Alexander Bowmanville, Ontario L'honorable Lincoln M.Alexander L 1C 3A6 The Honourable Henry N.R.Jackman Attention: Charitv Roster Applications L'honorable Henry N.R.Jackman Advance Funding Oscar Peterson C,C. Please find enclosed our Advanced Funding Application Veronica Tennant O.C. to the Municipality of Clarington. This funding would allow Ontario March of Dimes to assist adults with physical disabilities in the Municipality of Clarington Honorary Chair/President honaraire through a variety of programs we offer in this The Honourable David R.Peterson, community. P'C"°'C In the Municipality of Clarington, Ontario March of L'honorobie David R.Peterson, Dimes spends thousands of dollars every year purchasing cP rr mobility equipment for adults with physical disabilities . In addition, our organization provides Post-Polio Support and Camping and Recreation Programs President/President to residents of the Municipality of Clarington. Duncan P.Read Ontario March of Dimes believes that the best way for adults with physical disabilities to achieve independent and fulfilling lives is to enable them to Executive Director/Dlrectrice generals choose for themselves the tools they need to enhance Andria Spindel their independence of movement, job skills, lifestyle and housing. Our organization works with adults with disabilities in obtaining devices that facilitate basic Charitable Registration No. mobility and communication, and provides a range of No enreg.oeuvre de bieni. services designed to help people increase their income opportunities and shape their future wits-. our 1eN) 107883928RR0001 Employment Services Program. Ontario March of Dimes operates a variety of recreation programs for adults with disabilities, through our Camping and Recreation Central Region Program and our Post Polio Support Groups, and through P.O.Sox 2220,City Hall Complex an established registry, provide the latest information on Post-Polio Syndrome to post-polio survivors. In Oshawa,Ontario addition, through our Independent Living Assistance L I H 7v5 Program, Ontario March of Dimes attendants provide non- medical assistance to adults living in their own homes and in certain non-profit housing projects . Region du Central C.P.2220,Complexe de l'hotel de ville Our organization is requesting $6, 000 from your municipality to assist us with a number of projects we Oshawa lOntarial seek funding for. Dollars from the Advance Funding L1H 7v5 program will be used to purchase mobility equipment (ie. walkers and wheelchairs) for adults with physical disabilities living in the Clarington community, Tel./Telep.: 19051 4345280 Fax/Telec.: 19051436-2862 Web site/Site Web: www.omad.org THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON Memorandum To: Mayor and Members of Council FILE COPY From: Marie P. Knight Stanley, Deputy Clerk Date January 8, 1999 Subject: SCHEDULE 3 TO REPORT CD-3-99 — GPA — JANUARY 18, 1999 APPLICATIONS FOR ADVANCED FUNDING I attach herewith 31 Applications for Advanced Funding and related correspondence. We have not copied the volume of paper work received with the applications for costs saving purposes. However, this documentation is available in the Clerk's Department for your review. The applications have been numbered for your ease of review and discussion. Please note that Application #28 — St. Elizabeth Health Care, is incomplete. A letter was forwarded and several telephone calls were made to this organization advising of the deficiencies but no response was received to meet the deadline of November 27, 1998. It should be noted that although the Province has advised that: "...organizations wanting to access advance funding may do so by applying to their LOCAL municipality," it is left at the discretion of Council whether or not a grant is approved depending on how much the local municipality benefits from the efforts undertaken by the applicant organization which does not have a home base in Clarington. Respectfully submitted, Marie P. night tanley, C. 0., CMM II Deputy Clerk MPKS/hj cc: F. Wu, Chief Administrative Officer P. Barrie, Municipal Clerk M. Marano, Treasurer Department Heads (memo only) I i i j I i ADVANCED FUNDING ORGANIZATION HOME BASE AMOUNT REQUESTED SURPLUS 1 Association of Hospital Volunteers Clarington $ 9,600.00 $ 7,290.00 2 Bethesda Cemetery Clarington $ 25,000.00 $ 2,947.87 3 Bethesda House of Mercy Clarington $ 50,000.00 $ 25,749.00 4 Big Brothers of Clarington Clarington $ 95,000.00 $ 16,273.00 5 Bowmanville Eagles Junior Hockey Association Clarington $ 60,000.00 ($ 51153.64) 6 Clarington Concert Band Clarington $ 17,000.00 $ 4,471.07 7 Clarington Girls Hockey Association Clarington $ 10,000.00 $ 1,596.60 8 Clarington Minor Hockey Association Clarington $ 50,000.00 ($20,474.00) 9 Clarington Older Adult Association Clarington $ 80,500.00 $ 36,760.00 10 Clarington Swim Club Inc. Clarington $ 14,887.00 $ 12;807.20 11 Durham East 4H Council Clarington $ 5,000.00 $ 4,976.33 12 Haydon Community Centre Clarington $ 50,000.00 $ 2,611.88 13 Orono Amateur Athletic Association Clarington $ 50,000.00 $ 45,000.00 14 Rotary Club of Bowmanville Clarington $ 50,000.00 $218;485.38 15 Solina Community Centre Board Clarington $125,000.00 $ 52,961.05 16 The Visual Arts Centre of Clarington Clarington $ 14,253.00 $ 10,774.00 APPLICATION RECEIVED LATE — November 30, 1998 131 ( Ontario Lung Association I Oshawa 1 $ 25,000.00 1 ? ORGANIZATION HOME BASE AMOUNT REQUESTED SURPLUS 17 Alzheimer Society of Durham Oshawa $ 10,000.00 $ 16,906.00 18 Autism Society Ontario Etobicoke ? $ 142,470.00 19 Big Sisters of Oshawa-Whitby- Clarington Oshawa $ 38,000.00 $100,,137.00 20 Canadian Cystic Fibrosis Whitby ? $ 3,181.00 21 Canadian Diabetes Association Oshawa $ 2,370.00 $ 96,'!356.00 22 Catholic Family Services of Durham Oshawa $ 20 000.00 $ 513.00 23 Durham Region Community Care Association Oshawa $ 14,000.00 ($ 55,'!375.00) 24 Grandview Children's Centre Oshawa $ 35,000.00 $ 40,000.00 25 Kawartha Child Care Services Peterborough $ 5,000.00 $124,763.00 26 Kinark Child and Family Services Don Mills $ 11,119.00 ($450,086.00) 27 Rehabilitation Foundation for the Disabled Operating as Ontario March of Dimes Oshawa $ 7,000.00 $683.317.00 28 Saint Elizabeth Health Care Whitby ? $110,825.00 29 The Canadian Red Cross Society Oshawa $ 25 842.00 $ 0 30 The Community Foundation of Durham Oshawa $180,000.00 $ 53,489.00 APPLICATION RECEIVED LATE — November 30, 1998 131 ( Ontario Lung Association I Oshawa 1 $ 25,000.00 1 ? APPLICATION #1 Oehrle Lottery Comonoon 30d6M des lolertes do 1'04tsNo )Foster Drive.Suite 800 Please see attached page of instructions, quit Ste.Marie.Ontano P6A6V2 - Please print or type - 1. Previous charitable gaming licence . Has your organization ever applied for a charitable gaming event licence? No 7 Yes(If yes) What is the most recent licence number issued by: - - - - AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? F-]No ❑Yes 2. Information on organization GIN a) Incorporated or legal name ASSo�cr q'r ro 1r Of 40WO-II117046- VOL,wrra: m r►w>*wr�a,� I Street address of organization iew Province *? i•, �►�1rt�rti bT 1A� S •TN 1"IA1wvr�.c o y Postal Code Telephone No. Fax No. 1 Loil 04k A 101:5 ) to, Mailing address(if different) Postal Code b) Is your organization incorporated as a non-profit organization? ®No F�Yes(If yes) Jurisdiction of Incorporation number Incorporation C) Is your organization registered as a Charitable Organization with Revenue Canada? ❑No Yes(l1 yes) I 1 I ;I A I X *I * Revenue Canada Reg number d) How long has your organization existed? What is the financial year end of your organization Years I Mart. Month I Day 3. Affiliates Is your organization affiliated with any corporation or organization? No' 0 Yes It yes:'List the legal Names(Attach separate sheet if necessary) a).• b) 4. Use of net'proceeds = What will the advance funds be used for?(Attach separate sheet ifnecessary) a) b) C) d) Questions? Call 1-800-387-0098 OLC CAP 001(98/05) Continued on bock 5. Lottery trust account Name of financial institution where lottery funds are held Account number Address City 6. Unorganized Areas Is your Charitable organization located in an unorganized area? 0 No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENORA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: y yp • I/we are a Principal Officer of this; r ,ization.;� „ • I/we are NOT receiving remuneration directly or indirectly from the advance funding, ` I/we have beten'authorized to make this application on behalf of the organization. w • • Uwe agree to deposit all advance funding into.,the designated lottery trust account; • I/we agree to use the advance funding for approved charitable purposes only • 1/we will sponsor table game events at the local charity casino, • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete, We have read and understand the entire Declaration above. Principal Officer Principal Officer nature:.JI_( Print.name in lull ru Z KiE H'�!01goZ Diu. S►k•N1S ?QEs.����►� Title lsw y�c.� pare r � 4A Bitiness telephone number 17` (44 IO ) 4III;I - 11%IO 11 AO Is i6PIa I I — i illkl I bate Signing Providing inaccurate information may render your organization ineligible for advance funding;'. Questions? Call 1-800-387-0098 Ce formulaire est oussi disponible en frongais. 1 AS"S'OtCIAMN OF MOS'PIM VOLU'IVTIFERS - BOWMANvILLr August 31, 1998 Garth Manness, President Ontario Lottery Corporation 70 Foster Drive, Suite 800 Sault Ste. Marie ON P6A 6V2 Dear Mr Manness, Our Association has grown to the point where it is necessary to have an office in the hospital in order to give better service. The office will need to have a desk and a computer, etc. to enable us to keep volunteer records; minutes of meetings; newsletter; mailings and monitor daily activities. Attached is a breakdown of what will be required to set up an office. All monies raised by our Association are used to purchase equipment and other items as requested by our hospital - Lakeride Health Bowmanville. See 1997/98 Budget attached. We trust our application will meet the guidelines as requested. Sincerely June Hunter President 47 Liberty Street South, Bowmanville ON L1 C 2N4 "S'OCIATIOA/ OF MOS'PIM lVOIU'NTFERS - NOWMANVIIIV BREAKDOWN OF ESTIMATED COST OF SETTING UP A VOLUNTEER OFFICE Desk $500.00 Filing Cabinet $500.00 Office Chair x 2 $400.00 Shelving $200.00 Computor $5000.00 Laser Printer $2500.00- Sundries: $500.00 Stapler Hole punch Files Paper tray etc. TOTAL $9600.00 < "' 47 Liberty Street South, Bowmanville ON L I C 2N4 APPLICATION #2 v Oehrto Lottery CoryonOoe 8odit6 des totedes de 1,0081to 70 Foster Drive,Suite Boo Please see attached page of instructions, Sault Ste.Marie,Ontario P6A6V2 - Please print or type - 1. Previous charitable gaming licence . . e Has your organization ever applied for a charitable gaming event licence? [i�No 7 Yes(If yes) What is the most recent licence number issued by; AGCO. P Municipality; M Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? L 'NO ❑Yes 2. Information on organization GIN a) Incorporated or legal name BeAheda Ce-fider Street address of organization City Province CO/7 c e5;50)1 5 esd�t 4'14/ %/� �",601nQ/7 0 O/Y Postal Code Telephone No. fax No. Mailing address(il different) /, Postal Code S�cu 0 Q L�17 n 1 Sfi Ilen ()/V 4 01146 Ait 4 b) Is your organization incorpo ated as a non-profit organization? l o 0 Yes(If yes) Jurisdiction of Incorporation number Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? / No �es(If yes) I g I g l l (, Revenue Canada Re number d) How long has your organization existed? What is the financial year end of your organization ^ Cemefery has QXistuf /-20fy,yr'ar S Month Day Years Ce fiery board has exisl d,30t fears I deg. .. � 3. Aff iliates V No organization affiliated with any corporation or organization? Yes If yes: List the legal Names(Attach separate sheet if necessary) a) b) 4. Use of net proceeds �O What will the advance funds be used for?(Attach separate sheet ifnecessaty) `� ' a) b) /,T_rl/ rye/l �) ar �e e �7 Valpel� d) e _S�e� /� /DD, Questions? Call 1-800-387-0098 OLC CAP 001(98105) Continued on back I 5. Lottery trust account Name of financial institution where lottery funds are held Account number ��k C rn.��PAC C'aha��l'a n ��„ e�-i�� 0 1; 11 Addressv L City 6. Unorganized Areas Q C `3 Is yo Charitable organization located in an unorganized area? No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only, • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete, We have read and understand the entire Declaration above. Principal Officer rinci al Off lo6r Signature:': ��r✓ / Print name in iuii H "' Business telephone number 15 ) A6131 - 1,�1910 iC�? Date Signing g Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est aussi disponible en frongais. Bethesda Cemetery Board c/o Lynne Piggott 7762 Old Scugog Road Enniskillen Ontario , LOB IJO Marie Knight 40 Temperance Street Bowmanville Ontario , LIC 3A6 November 24 , 1998 Dear Marie ----eth-esda 'Ce.-mete-Iy no-rdt I am applying for an Ontario Lottery Corporation grant 'to help fund sever'al the cemetery : 1 ) There are many ancient stones at the I cemetery which are in need of being repaired/replaced . The board has recently repaired four stones at the cost of $2442 . 00 . 2) We urgently need a reliable source of water e . g , a drilled well . it is embarrassing for the board not to have an adequate' supply for the public to use as well as the hindrance imposed on the caretakers in the performance of their duties . We are left with no option but to continuously purchase water as there is rarely enough precipitation to even partially fill the cistern . 3 ) The chapel could use some repairs/improvements , etc , such as new interior lighting , sentry lighting for the parking/chapel area , more seating , roof , doors , etc . The grass/gardens and bushes/shrubs are endlessly in need of upkeep/replacement . 4) A new shed in which to store tools , burial mats , etc . is required to replace the one that was demolished by a wind storm. The services provided by the cemetery are: the sale of plots , opening and closing the grave , monument bases , cornerstones , and the maintenance of the grounds and chapel . Enclosed , You will find a copy of the service prices . The chapel provides storage of the deceased for the winter months and a place in which to hold services and'/or board meetings . There are eight board members who hold voting rights at the board meetings . Enclosed , You will find a copy of the member ' s names . Each member has a specific duty to deliver a particular service to clients . The board does not have an assigned operating budget . The funds that have accrued during the previous year ( from the sale of plots , cornerstones , monument bases , and donations , Plus matured investments if needed for a special Project ) minus expenses are those which the board uses to operate . Bethesda Cemetery _ 2 _ The caretakers and board members do their very best to keep the cemetery in excellent condition . The grounds and chapel are kept in good repair . The safety of those visiting the cemetery is an utmost priority . Due to the efforts of these dedicated people who take care of the cemetery , it is a location in the municipality that is pleasant to behold and visit . Primarily , because the board does exist , the municipality is not burdened with the task of dealing with yet one more responsibility . Therefore , a grant , to be used only for the perpetuation of the cemetery , would be greatly appreciated . As of the writing of this letter , we have four investments , one maturing in December , two maturing in 1999 , and one maturing in 2000 . The approximate total worth of these is $53 000 , 00 not including interest . These are usually re-invested , unless as was stated earlier , there is a special project planned . Once a year , the Public Trustee sends the board a cheque for the accrued interest on the money that is locked into the Perpetual Care Fund which usually amounts to between $900 , 00 and $ 1100 , 00 depending on the prevailing interest rates . I hope you will look favourably upon this application and allot a grant to aid in the continuation of the cemetery . Also , please find enclosed the application form, a copy of the bylaws , a copy of the letter from Revenue Canada regarding the registered charity number , and the original bank account statements for 1997 , Yours truly i Lynne Piggott (Mrs . Secretary/Treasurer Bethesda Cemetery Board Enclosures I I� APPLICATION #3 OnNdo Latlory Capntlo� JOHN Oa 1008d"to YOsNAo 70 Foster Orim,Suite 600 Please see attached page of Instructions, Sault Ste.Marie,Ontario P6A6V2 — Please print or type - 1. Previous charitable gaming licence . Has your organization ever applied for a charitable gaming event licence? ®No 7 Yes(If yes) What is the most recent licence number issued by: - AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? ®No ❑Yes 2. Information on organization GIN a) Incorporated or legal name e6pes� Street address of organization City Province ( '�I Li bet- Se - -v� o1� �Postal Code Telephone No. Mailing address(ifdil/erent), ?2— Posttal Code � ? t b) Is your organization incorporated as a non-profit organization? No ®Yes(If yes) �q) Jurisdiction of Incorporation numhe Gj'® � L Incorporation ()(ld rO C) Is your organization registered as a Charitable Organization with Revenue Canada? no (e q, (Dt1 �eiti(_ l;10�6�e ❑No [�Yes(lfyes) �I Revenue Canada Reg,number 1-1 I I I_ 1,51,5191-7 I IQ IP d) How long has your organization existed? What is the financial year end of your organization Month Day Years ©3 ( �3 I 3. Affiliates Is your organization affiliated with any corporation or organization? ®No Fj Yes If yes: List the legal Names(Attach separate sheet if necessary) i a) b) 4. Use of net proceeds What will the adva nce funds be used for?(Attach separatesheetifneces_sal}y) ++ i a) Mr h) Questions? Call 1-800-387-0098 OLC CAP 001(96105) Continued on bac S. Lottery trust account — /Name of financial Institution where lottery funds are held Account numbeerr Address i nfi �Ity � ��M Me> LIB N(o 6. Unorganized Areas NOV Is your Charitable organization located in an unorganized area? No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • 1/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. _ Principal Officer Principal Officer , ( � Print name In'tali 091a,( ' 600M d N(ObCS Title U( / n Business telephone number I ( 1 I LN i l� Ip `�" -qtr t date Sipninp O Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponible en fronGois. trrs APPLICATION #4 Ontario Lottery Corponfloe sodef6 des loferies de 110018110 70 Foster Drive,Suite goo Plaase see attached page of instructions. Sault Ste.Marie,Ontario P6A6V2 - Please print or type - 1. Previous charitable gaming licer,ice FOR Has your organization ever applied for a charitable gaming event licence? 7 No VfYes(If yes) IV�,)4,/j - f3k'r,gk- 6t-�" v';ICKF 73 What is the most recent licence number issued by: AGCO: P Municipality: MUG X, Have you had gaming event licences cancelled or licensing Q'No Yes privileges suspended in any juridication in the last two(2)years. 2. Information on organization GIN a) Incorporated or legal name Street address of organization Clty Province -3 C 6� (t u 6,;; : .S7-r�'E-E i" l9 L(C T b/fi i Postal Code Telephone No. Fax No. Mailing address(if different) Postal Code b) Is your organization incorporated as a non-profit organization? 0 No Yes(If yes) /g /;C,/ Jurisdiction of �� . Incorporation number' '7 `7 Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? (� r No Yes(Ifyes) I Revenue Canada Reg number. ✓' I 0 1 171 1 131 I I C I�I/l I� CI d) How long has your organization existed? What is the financial year end of your organization _ _ Month I Dr / Years ay� � Co � �� 3. Affiliates Is your organization ffiliated with any corporation or organization? /rJOCl�t,l T U���-� 9�et No Q Yes if yes: List the legal Names(Attach separate sheet if necessary) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet ifnecessary)(sG' C 1 /I i Questions? Call 1-800-387-0098 OLC CAP 001(98/05) Continued on back Lottery trust account Name of financial institution where lottery funds are held Account number Address City C IA16 ' )7' 6. Unorganized Areas Is your Charitable organization located in an unorganized area? E�No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑__RAINY_RIVER_UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • 4AYe AvW-spansoLtable,game._events at the-local-charity casino: N • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer / signature Print name in full `LL L�) fD�9A-'�I E W 19 S L1 11�E K Title jRFS/ J EAIr- c.ll6 1 Business telephone:number Vi 17i - 13161 � 3 f� Providing inaccurate information may render your organization ineligible for adva ce funding Questions? Call 1-800-387-0098 Ce formulaire est oussi disponible en fron(�ais. ® BIG BROTHERS OF CLARINGTON 23 Scugog Street, Bowmanville, Ontario U C 31-17 Tel:905-623-6646 Fax:905-623-0704 November 26, 1998 Municipality of Clarington 40 Temperance St, Bowmanville, ON L1C 3A6 Re: Advance Funding Application Big Brothers of Claringon was established 21 years ago to provide for boys the stabilizing and helpful influence, guidance and friendship of mature, interested and responsible men who could set a good example which boys could follow. Throughout the years Big Brothers of Clarington has expanded its services to further meet the needs of the children of our community. See Section C on Services. While expanding our services we have maintained a small staff, but, in order to continue to grow to meets the needs of our growing community we must have more hours for the current staff. A Recruitment Officer would be beneficial to recruit potential volunteers to serve as Big Brothers, Mentors, Big Bunch Buddies, Board or Committee Members.. Funding for the services provided by Big Brothers of Clarington is raised directly from the Clarington Community. As we do not receive 9"goi g government fund�n g or lame corporate donations it is imperative that we have the opportunity to access the funds available from Advance Funding. We feel it is important that these funds stay within the community. Currently our financial situation is very good. Through hard work and the support of the community we have been able to secure the funds needed to provide our services to the children of the community. However, as we are dependent on the community for our sole survival our financial situation can change drastically from year to year. In July 1995, we lost our Nevada location and the agency was without these funds for 15 months and it was only because we had a contingency fund that we were able to make it through 1996. Last year we were facing a huge deficit in funds but through cost cutting efforts (such as accepting no new Little Brothers and working with only two part time staff and fundraising we were able to survive. Big Brothers of Clarington is asking for $95000 to increase staff hours, upgrade office equipment and for recruitment materials. (See Section C page 5 for a breakdown). These funds will allow us I i Share the Fun-BE A BIG BROTHER A I lniforl IN-A--, to expand our service delivery, fundraising and recruitment to meet the needs of our rapidly growing community. The programs provided by Big Brothers of Clarington are very beneficial to the community since they are preventative and will have long term ramifications to benefit the future of the children of the Clarington Community. "Our main goal is to aid in the healthy development of children at risk through the auspices of a caring adult role model." (Big Brothers and Sisters of Canada President, Ruth Kelly). Our programs have the ability to produce a healthier community and with the growing population in the Municipality of Clarington the need for our programs will only increase. A supportive neighbourhood can do wonders for a child even"one caring adult can turn a child's life around." (Ontario Health Study 1994) Thank you for considering our application. Big Brothers of Clarington look forward to hearing from you soon. Sincerely r Nancy Scot/ Executive Director - APPLICATION #5 �Yf.ivxcrtr�f� .v Mr WT OrUrla I offery Corpaillor Sodttt ter lofrdu tr 1'0rfrde �oFnslerori�.sUireeoo i Please see attached page of instructions. Sault Ste.Marie,ontalia P6A6v2 — Please print or type — 1. Previous charitable gaming licence FOR • • Has your organization ever applied for a charitable gaming event licence? No ©Yes(If yes) What is the most recent licence number issued by: AGCO: P Municipality: nn S� 9(ob ' Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? �No Yes 2. Information on organization GIN a) Incorporated or legal name •t / ��'r:!t�� <I1✓G>iGL iL �'flfiG/'d l/L,Z�✓i�/L hocIC/L7'�SS' Street address of organization el.?/3— TOpGii y /yd City/ Province �'ou,r'.ii c-� �.dirJ.�j� C F?LriLi�c':L ��✓i Postal Code v Telephone No. ;/ Fax No. L11 Li ICI /'" ( �iOts ) 7kI41 - 12116th ( ` ,QtS) Si�I — 16t�il.Zl� Mailing address(il dilfeierl) i Postal Code I 1 I I b) Is your organization incorporated as a non-profit organization? No ®Yes(11 yes) Jurisdiction of Incorporation number 6&a Incorporation ✓i�/�1 a c) Is your organization registered as a Charitable Organization with Revenue Canada? I No Yes(11yes) i Revenue Canada Reg.number I i d) How long has your organization existed? What is the financial year end of your organization Month Day Years �G✓h.r: /�i.✓ii I �`7 I J / 3. Affiliates Is your oreanization affiliated with any corporation or organization? No ©Yes!I}res: List the legal Names(A7eah separate sheet i!necessary) b) Oo 4. Use of net proceeds �t What will the advance funds be used for?(Attach separate sheet ilnecessafy) ) C) d) Oueslions? Call 1-600-387-0098 ac GP 001 n!'osi Continued on boc% 5. Lottery trust.account Name of financial Instltutlon where lottery funds are held Account number �} Address ( City 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ONO ❑Yes (l1 yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned. declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application.as well as all the information contained in the documents and materials submitted vzith it are true and complete. We have read and understand the entire Declaration above. Prin4i al offlo Ir Principal Officer ..•.Signature- .' _ ��' � � � 'Print i ame in full n '_Title _t !I ' Busines telephone number;ol 91 — I 1 L) c� T101 SS t 711 — fCll /I� -� Date 12, Di v fSigning,_ �wr / J Providing inaccurate information may render your organization ineligible for advance funding Questions? C211 1-800-3i7-0098 Ce formulairr es;cussi dispOn;,)�--en frJnGoa. APPLICATION #6 Ontario tottery Corporation sodild 0Fosl Jearie,Suil POn0 Please see attached p gue ` instructions. IOFoslerDrive,5ai1e600 �Ou �Ypei f �� ��� ��� &,ullSte.Ma,ie,Onlario — please grinii or — P6A 6V2 1. Previous charitable gaming licence FOR ' ' Has your organlzati ever applied for a charitable gaming event licence? Fj N o (11 yes) What is the most recent licence number issued by: AGCO: P Municipality:M ®69 3 Have you had gaming event licences cancelled or licensing No El Yes privileges suspended in any juridication in the last two (2)years? 2. Information on organization GIN a) Incorporated or legal name C k A R,,J %,J �' o e4 C - T 94^J Street address of organization Ci"y Province 0 . Q o C 7 D Ro n1 n o 1,j i Postal Code M Telephone No. —�Q E S t p E�rT— -ax No. Mailing address(it ddlefent) l Postal Code 1 I I b) Is your organization incorporated as a non-profit organization? 9<0 Yes(l yes) Jurisdiction of Incorporation number I Incorporation C) Is your organiza!ion registered as a Charitable Organization with Revenue Canada? No [0'es (It yes) Revenue Canada Reg nufrti d) How long has your organization existed? wliat?s!�_ii;ancial year end of your organization Month Day Years �o yC �S 3 O 3. Affiliates Is your organization affiliated with any corporation or organization? !o F-1 Yes It yes: List the legal Fames(Attach separate sheet it necessan) i a) b) 4. Use of net proceeds ©o What will the advance funds be used tor?(4;lach separate sheet it necessary) a) (YI Lk c c b) IPc RC uS S f o ^j U tj GoKIrt S C) n1 �n1 C'.C7� fir.�'A ot� d) �,�Is 6 q10W POW I Questions? Call 1-800-387-0098 Continued on boc: OLC CAP 001(ga/05) 5. Lottery trust account Name of financial institution where lottery funds are held Account number 1-11) f3 A n1 Address City O ri , 6. Unorganized Areas F y ur Charitable organization located in an unorganized area? No Yes(If yes,please indicate) ALGOMA UNORGANIZED F] PARRY SOUND UNORGANIZED F] COCHRANE UNORGANIZED n RAINY RIVER UNORGANIZED KENORA UNORGANIZED ❑ SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • [/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principat Officer Signature U LFD RQ� Print name in full J J V S fUr N i Tide SEa PRE RcR� Business telephone number; 4I 1I 6 ` " 1 I Date Signing Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponible en frongois. The following is an itemized list of where the band intends to use the advance funding (if awarded such) monies: Incorporation $2,000.00 Percussion accesories $5,000.00 Music purchase $5,000.00 Sand Uniforms 5 Op0.00 TOTAL $17,000.00 I I APPLICATION #7 041arlo lottery Corporoo, SoddN oq loled„do l•O0,do 70 Foster Drive,Suite 800 Please see attached page o instructions. Sault Ste.Marie,0n1ari0 r6A6v2 - Please print or type - 1. Previous charitable gaming licence . - OFFICE Has your organization ever applied for a charitable gaming event licence? X No F-]Yes(11yes) j What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No I Yes privileges suspended in any juridication in the last two(2)years? — 2. Information on organization GIN a) Incorporated or legal name / 1. J 7" to I U 5 146 C i« r I I Street address of organization Cii` Province ; a ) 7 f L L - 1 OIVT Postal Codle Telephone No. Fax No. ` 9' e / IMI5 ( 7 06) 61 l I — I f 0S91�� (91��L�)C_�L� 131 — 1611 IA 21 Mailing address(il dillerent) � Postal Code b) Is your organization incorporated as a non-profit organization? ®No Yes(11 ycs) Jurisdiction of Incorpoation number Incorporation c) Is your organization registered as 3 Charitable Organization with Revenue Canada'? X No [j Yes(11 yes) I Revenue Canada Reg,nu- d) Ha..Icng Fas your organization existed? �':`•_: .:-e financial yez-end of your organization Month Day Years_'_' F'r y� (67� ) I X14 I a k 3. Affiliates 1O o Is your organization affiliated with any corporation or organization? No ©Yes If yes: List the legal Names(Attach separate sheet it necessE-,.1 a) 05Heo_otA GIRD 1 YKI y � cc�H�r06) 4. Use of net proceeds What v:ill ;^e advance funds be used for?(Attach separate sheet it necessary) a) nU QIA)AME/1J T b) Questions? __II 1-800-387-0098 i Continued on bock OLC CAP 001(? ,5) 5. Lottery trust account Name of financial institution where lottery funds are held Account number Address City 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No Yes (If yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENORA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED F] TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • 1/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature �-- Print name in Lull Business telephone number � '/ L, IQ131 - 11L5191 (� It)I,15) / I �1q, - 101 TI�I Bate Signing.- - f / f NQ 0, �Pi � ��t 7 Providing inaccurate information may rendeit your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formu!c::e°sf oussi disponible en frongois. 85 Pueen Street BQWMANVILLE, Ontario LIC IM5 amp' 905-623-1592 LR1�C�rIO November 26, 1998 GirCs .Hockey Town of Clarington association. 40 Temperance Street BOWMANVILLE, Ontario HAND DELIVERED Dear Sirs: z 0 Re: Charity Roster Application - Advance Funding Ontario Lottery Corporation 4 Enclosed herewith please find the following: w Q N 1. Copy of Clarington Girls Hockey Association Constitution and By Laws 2. Letter detailing the outline of programs/services 3. Operating budgets for 1998/99 and 1997/98 4. Financial Statements for 1997/98 5. List of Board Directors 6. Application reguesting the amount of$10,000.00 Trusting this is satisfa,dory and we look forward to hearing from you at your earliest possible convenience. Yours truly, i Beverly Fergus n Encl. - 6 I i MOW LARINGTON Gids Hockey Association DETAIL OUTLINE OF PROGRAMSISERVICES The programs and services offered is organized hockey for females between the age of 6 to 18 years of age. This allows the girls to develop their leadership skills, as well as athletically, with their peers. At present we have an interlock agreement with the Oshawa Girls Hockey for house league. This allows the girls to play a variety of teams within Clarington & Oshawa in the::own age level. Clarington Girls Hockey is attempting to run their first annual Spring tournament this March, which will be an Association tournament. This is to be held at the Garnet B. Rickard Complex. We are planning on having the girls involved in every aspect, allowing them to obtain knowledge in how to organize and run this event. With all the media exposure about abuse in sports it is our intention to have every volunteer obtain a police check and attend a clinic pertaining to the above, which will be done through our local Red Cross. This is to provide the girls with a save environment in which to learn the skills of hockey and have fun. Clarington Girls Hockey is planning on expanding to the competitive level of hockey, as the growth requires. At the present girls from our area are venturing to Toronto or Pickering to get this exposure. We would like to build our organization in order to have our girls given the same opportunities as minor hockey in our area provides. In order to do this we must have the ice and the money to pay for this. We look forward to your help in forming a bright future for the girls in the Clarington. i i APPLICATION 18 • .fir.;.",.�ra4'- �'! .r.::•. Ormla r atley C"woif*. SadlN Ot lafed,r It 1'0drda 10fostefodw,Suite 800 Please see attached page of instructions. &w/1 Ste.Marie.Ontario r6A6v1 — Please print or type — 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No gYes(11 yes) o t What is the most recent licence number issued by: ry AGCO: P— N Municipality: .� M- 5 ry Have you had gaming event licences cancelled or licensing �No Yes privileges suspended In any juridication in the last two(2)years? ra 2. Information on organization GIN a) Incorporated or legal name CL09RIMGTbN MINOR Noc145 AsSMILDOM C i M S 1 i 14 1 5 Street address of organization city Province f -PC. Box I I IBCWMANv1L-� I ONrqRjb Postal Code Telephone No. Fax No. L I l IC 3 K (q C G U 4i3 _ 3 _ 713 IS Mailing address(il dilterert) I I Postal Code SAME l b) Is vour organization incorporated as a non-profit organization? O No Yes(Il yes) ,,{{ Jurisdiction of Incorporation^umber ` 1488 Z I Incorporation (ON Tiq H I C c) Is your orgytii:gtion registered as a Charitable Organization with Revenue Canada? dNo E]Yes(Oyes) + R I Revenue Canada Rxg number d) Ho'a long has your organization existed? What is the financial year end of your organization LC-MER Pffi-ENT i�°7� Month Day Years 27 SIMCE 19`71 , 0S 1-13 3. Affiliates Is your organization affiliated with any corporation or organization? O No dyes 11 yes: List the legal Names(N'taSh separate sheet it necessary) z) GWARIO M IMOR Nal!-KEV A ZSoC(RT1UJ b) DINADIOM Amxreap, (-odc-y ASsocouo 4. Use of net proceeds 1 OCX-D What will the advance funds be used for?(Attach sVarale shed itnecessary) Z,:DErI Crr REDUCTI(:)M b) EgUI PMt: I-r- SWEA1--R3 sow CKS,_REPAt C, S�E THE �EnfrRL�exPctysE d) ADMIN)STEOTI-C&I OFFICE s�PLIt=0. Questions? Cail 1-800-387-0098 S. Lottery trust.account .-.. Name of flnanclal institution where lottery funds are beld� Account number Address City 6. Unorganized Areas Is your Charitable organization located in an unorganized area? [N No ❑Yes Ill yes,please indicate) Q ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer lJ - PA L. R• JAckmhM 'Print name in full `� m �G�LE� n'1 �'2yc�-PMtgA) `riil� Business telephone number; /,, { 91D1� ) 1p12131 — 191 131P� ; � Imo ) Lt �31 I(0 '- d Gate Signing: I Providing inaccurate information may render your organization ineligible for advanL-e funding Questions? Call 1-800-3.&,-,-0098 Ce formulciree es.'cussi disponiVe en fronGois. fe. - _ CLARINGTON PO. BOX 191 MINOR HOCKEY ASSOCIATION BOWMANVILLE ONTARIO-CANADA BOWMANVILLE (formerly Bowmanville Minor Hockey Association) L IC 3K9 Municipality of Clarington Attention: Marie P. Knight Deputy Clerk Ms. Knight, please accept our application and supporting documentation as our request for financial assistance as per the current Ontario Lottery Corporation, Advance Funding Program. On behalf of the Clarington Minor Hockey Association, Paul Jackman the President, and myself(Mickey Cryderman-Treasurer) request consideration to have our organizations' name included in the roster of applications to be reviewed by the General Purpose and Administration Committee on January 18, 1999. To the best of our ability,we have included all supporting documents as requested. If you have any questions please feel free to contact myself or Paul at the numbers listed below. Thank-you for your consideration, VT�-Cq& Urj11:21/-y—j I Mickey Cryderman Pau Jackman Treasurer- C.M.H.A. President- C.M.H.A. (905) 623-6360 (905)623-9538 i i C,M,H.A. OFFICE PHONE/FAX(Oct, 1st-April 1st)(905)263-7825 November 27, 1998 DEC I 3 is PM '99 Charity Casino- Advance Funding Review Team: This letter portion of our application for the advance funding is to notify you of the amount of dollars the Clarington Minor Hockey Association is requesting. Our association is grateful for any amounts of money with regards to grants or donations from any and all sources. In complying with your request to include an amount requested with our application, I would ask to first explain our current and projected financial status. During the past 3 seasons a number of issues have put a huge financial burden on our program. The first being our associations name change from Bowmanville Minor Hockey Association to the current Clarington Minor Hockey Association. This was done to better reflect and represent the name of our Municipality and the tatal area from which we select our players. This meant the need to change 34 full sets of sweaters, designing of a new logo, letterhead, envelopes etc. as well as the legal costs for the incorporation name change. This had an approximate $30,000.00 dollar impact on our association. During the past 2 seasons with the overwhelming growth of our area, we found a need to expand our program to accommodate the large number of players with the skill levels to play representative hockey. In order to accomplish this our association had to travel outside the Municipality to secure enough ice time to ice our teams. We traveled to Scarborough, Pickering, Whitby, and Oshawa arenas in order to maintain the quality level of our program. As you are probably aware, ice time costs for outside of community residents is at a premium, and we paid in most of those outside arenas 2 1/2 times the fee for 1 hour of ice as opposed to ice fees here in Clarington. In order to secure ice time at The Ice Palace in Oshawa lasts season, our association had to pay in advance $55,000.00 dollars. Enough said about ice time. The final issue is our association has been granted"AAA" status for next season(1999 - 2000). This is the highest level or"elite" level of hockey offered to players at the minor level. This is in part a reflection on the quality program Claringtons volunteers have been organizing and operating for many years. It also places Clarington as a community into a league with the large elite centers and will undoubtedly have a positive impact on this area in the future. Having said that, there will be a need to purchase some new sweaters again to start replacing sets that are becoming worn. There may need to be a change of our hockey pants and helmet colours (due to manufacturer availability of our current red colours). At this time our estimate for replacing used sweater sets next season is $10,000.00. In closing, we have included with our application, an audit from Laing McHardy&Rohr, Chartered Accountants, which reflect the current debt load of our association at $20,400.00. In an effort to improve the Clarington Minor Hockey Association to the elite level and have it remain affordable to all the youth of our community, we are humbly requesting advance funding in the amount of$50,000.00. If you require additional information or have any questions, please contact either myself or Mickey Cryderman, our Treasurer, Sincerely, Paul Jackman Mickey Cryderman (905) 623-9538 (905)623-6360 i i Review Committee: The Clarington Minor Hockey Association promotes, encourages,and governs organized hockey for boys and girls eligible to compete in OMHA hockey representing Clarington, under the governing body of the Canadian Amateur Hockey Association. Our hockey program is comprised of 16 teams from Minor Novice age to Juvenile age(ages 7 20). This level of competition involves playing other towns and centers " and is referred to as "representative" hockey. The program involves practices, goalie clinics, classroom instruction,tournaments and games. Our main reason for applying for these funds is that our organization began our 1998- 99 fiscal year in a $20,000 deficit. There are many reasons why this debt has occurred. Three years ago,we changed our organizational name from the "Bowmanville Minor Hockey Association" to the "Clarington Minor Hockey Association'. This name change was done to reflect the new name change of our Municipality of Clarington. However,we incurred a large equipment and administrative cost to reflect this change. Also, in order to provide the level of hockey we do offer, our organization was forced to go outside of our Municipality last year to acquire enough ice time to house our 16 teams, as the ice offered in Clarington was not sufficient. This ice was secured in Oshawa but the cost per hour was almost double our rate in Bowmanville. These actions have left our organization heavily burdened in debt. Our association organizes and operates 4 tournaments per season. We host teams from Ontario, Quebec, and the United States. These tournaments are run over a weekend,therefore, our community of local restaurants, hotels,and businesses acquire these economic benefits. Our Executive is diligently working this year to alleviate this debt and be creative in our fundraising attempts so as not to drive the cost of a child playing hockey so high that it would be unaffordable to many families. We thank-you for your consideration and we will appreciate any amount of money to help alleviate our current deficit. Yours sincerely, Mickey ry erman P ul Ja an Treasurer Preaent Clarington Minor Hockey Association Clarington Minor Hockey Association i APPLICATION #9 Oebda r onvy corponlloa SOCIN{del loledn do 1'001ido 70rosletotive.Suite 800 Please see attached page instructions. Sall Ste.Marie.Onlario P6A6v2 - Please print or type - 1. Previous charitable gaming licence • • • Has your organization ever applied for a charitable gaming event licence? No [ZYes (11 yes) What is the most recent licence number issued by. AGCO: - P Municipality-M 0 6,9-g Have you had gaming event licences cancelled or licensing �No Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization I GIN a) Incorporated or legal name J �1 Street address of organization City Province (0 13 C1:G )-I- u o A--i\) V i t"2i Postal Code Telephone No. — l/C� Fax No. 9 1 L-I ( IC I TI 1 19-1 I J )�O I t l�► — I / ►61—j�� Mailing address(1 ddlerenl) i Po slat Code b) Is your organization incorporated as a non-profit organization? [—]No P<Yes I Jurisdiction of Incorporation number (2-7E'7 9- j 1 Incorporation !v.1 ( 0 c) Is your organization registered as a Charitable C.canization v.ilh Revenue Canada? 0 p 0 I ❑No Yes (Il yes) � I (o 1 `71`2-0141 0 i 9 ill I 1 j Revenue Cana a Reg.num,. d) Ho',.,long has your organization existed? Wha: -_;,rancial year end of your organization Month Day Years I � � 3. Affiliates Is your organization affiliated with any corporation or organization? T<No Yes 1l yes: List the legal raTes(Allach separate she--.Pnecessary) a) b) 4. Use of net proceeds C:�o What will the advance funds be used for?(,:;ach separate sheet it necessary) a) f-/eQ,/ y �'-0 e 6XJ`r�'uc�a�,'r1 Jdt��'7rJb) C) d) Questions? Call 1-800-387-0098 OlC CAP 001(9e105) Continued on boc 5. Lottery trust account Name of financial institution where lottery funds are held Account number Address city 6. Unorganized Areas is you Charitable organization located in an unorganized area? Ill No ❑Yes(1l yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE_UNORGANIZED RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED F-1 THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED F� TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • 1/we will sponsor table game events at the!ocal charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and cornplete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature .. A-1 -Print name in full 4) IVA Title Business telephone number q 101 sal 6,219 01 — Ili I Date Signing to Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce iormu:c:'e est cussr disponibte en(rengois CLARINGTON OLDER ADULT ASSOCIATION Charity Roster Application -- Advance Funding ( a ) Computer Work Stations—(2) $4000.00 (To be set-up for Older Adults) (b) Software & Internet Connection $2500.00 (c) Additional Computer Work Station $4000.00 (For General Office) (d) Year 2000 Compliance $2500.00 (e) Elevator $40000.00 (f) Operations $27500.00 TOTAL REQUEST FOR ADVANCED FUNDING $80,500.00 I i i i i i i i REQUESTS FOR ADVANCE FUNDING It is our understanding that the advanced funding is for one-time grants; therefore , The Older Adults Association is requesting that consideration be given to assist them with providing the membership with the programs and facilities they need. The Executive want to make the Clarington Beech Centre a place where all the older adults in Clarington can use and meet their expectations. USE OF ADVANCED FUNDS (a) Computer Work Stations—2- Over the past few years computers have become a way of life for almost everyone from r children to seniors. Debit cards, bank machines and word processors are everywhere and most of the older adults have had to adjust to them. Some of the older adults have expressed an interest in computers and would like to learn more about them and have access to one. If a computer was available some of the older adults would make use of it for word processing and spreadsheet applications. (b) Software and Internet Connection If the Advance Funding is approved for any of the computer equipment, we will have to purchase software for these computers. User friendly software will be installed that will allow the user to do word processing and spreadsheets. These computers will also have the capability to connect to the Internet. (c) Additional Computer Work Station (for General Office) At the present time, the staff and the volunteers are using an older model computer that is very slow and too small to run some of the new software programs that would be beneficial to the overall operation. With a growing membership, more activities and scheduling of events the need is more and more evident a new computer is needed. A new computer would improve the efficiency of the office and optimum use of volunteers and staff. (d) Year 2000 Compliance The present computer in the Older Adult Office is several generations behind current technology and it will have to be upgraded before the year 2000. (e) Elevator The Clarington Beech Centre home of The Older Adult Association has three floors. At the present time all the activities for its members have to be on the main floor. When the basement renovations are complete we plan to have activities on that level as well and an elevator will be required by some of the older adults to have access. (f) Operations This component of the application is broken down into three sections. The breakdown is as follows. 1. Photo Copier $2500.00 2. New Carpet and Sub-Floor Repairs $5000.00 3. Folding Wall $20000.00 (1) Photo-Copier At the current time the Older Adult Association is purchasing this service from Community Care. Copies are being made on a daily basis and to improve efficiency and cost a Photo-Copier would prove very beneficial. (2) Carpet and Sub-Floor Repairs To maximize the use of the facility and increase the number of programs for the Older Adults the basement has to be renovated. A new carpet and repairs to the sub-floor will finish this room and entrance so it can be utilized and the older adults can enjoy two or three more activities. (3) Folding Wall When this facility was constructed it was designed to allow for a folding wall to be installed in the Large Activity Room. If this portable wall was installed the Older Adults would gain an additional room to hold an activity and it could be rented on some occasions that would generate more revenue and help offset the operating cost of the building. I APPLICATION X10 Oefala l ottery earpanflee sodeu des fofeder de roef.de 10rosleroliK.Suite 800 Please see attached page of instructions. S+;lll Ste.Marie,onlario 176A 6V2 — Please print or type — 1. Previous charitable gaming licence ' • Has your organization ever applied for a charitable gaming event licence? rNo aYes(1/yes) What is the most recent licence num er sue y: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No Yes privileges suspended in any juddication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name SwI M C�-v6 1 VC Street address of organization City Province Postal Code Telephone No. fax No. _ Mailing ad r?ss(il dillererl) I I Postal Code 1 b) Is your organisation incorporated as a non-profit organization? No Yes(it yes) Jurisdiction of ,,11 _ Incorporation number I Incorporation R 1 O Cam)4 O q c) Is yo!.'r org_;ization registered as a Charitable Organization with Revenue Canada? X,No El Yes(11 yes) Revenue Canada Reg number d) How long has your organization existed? What is the financial ti•zr end of your organization Month I �y Years I� ��c� S JU(i'1 3. Affiliates Is you oreanization affiliated with any corporation or organization? I o Yes 11 yes: List the legal Names(Ntash separate sheet it necessary) a) SWIPP% Oh oLr'f p b) _ 4. Use of net proceeds What wi0 the advance funds be used for?(Adachseparatesheel ilnecf ssary) a) P6 Re,7� ! b) 7—�i►-e �OSf s C) (! %CA( d) or 6Z <v c Ouestions? Cali 1-800-387-0098 Continued on boc� r.c car 00 1(3:-m) 5. Lottery trust-account .... _ Name of financial Instltutlon where lottery funds are Iield� Account number L) Address City G. Unorganized Areas Is your Charitable organization located in an unorganized area? ❑No ❑Yes(l/yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer "'��7�I/ .."`% •'car,..i �a)CAJ DY M l_)d -Print aame in iull: .�` CJ� lr(ot C.Tr f t9l�b ':rile - . SIc.-e— I U I �I Cjl� Business telephone number; r ,/1 J t /,7 , I /I I ► ` I(� I 1 (�j O U -Date Signing: ws Providing inaccurate information may render your organization ineligible for advant:e funding Questions? Call i-800-ss7-0098 Ce formu!cin e;;cussr disponidfe en fron(�is. '" YARINGTON INC P.O. Box 172 • Bowmanville ON L1C 3K9 Clarington Swim Club Advance Funding Program Application _ Funding Amount Requested: The amount requested below is related to loss of revenue from lottery sources(bingo,nevada)experienced since recent changes to Casino regulation brought in by the Province. Our primary financial need is to replace that lost revenue. We are requesting an amount equal to 2/3 of our experienced losses,with the intention of replacing the other third on a self-sufficiency basis. Loss of Bingo and Nevada revenue between 1996/97 and 1997/98 fiscal years: Bingo 96/97 $18,570 97/98 $12,610 Loss: $ 5,960 Nevada 96/97 $40,309 97/98 $23,938 Loss $16,371 Total reduction in available funds=$22,331 Requested Amount: $14,887.00 Clarington Swim Club Programs and Community Benefits The Clarington Swim Club is in its 13'x'year of operation. Beginning as a Summer club,then moving to full year operation with volunteer coaching,the club made the transition to professional coaching in 1989. The club attempts to provide full range service from first time competitors as young as 5 years of age up to Senior National Level. Membership is not restricted in-wry way-other than_themeed for_basic_swiunming ability and an interest in learning and pursuing the sport of competitive swimming. The club has and is capable of accepting disabled athletes from the community,and annually hosts a competition attended by a team of disabled swimmers from Variety Village. The basic concept of the programs offered is to allow each child to progress as far in the sport as they are willing to work towards. Selection is not talent based,however the club does provide some travel support at upper levels in order to make participation financially possible for those athletes who have reached that level of achievement but might be of limited means. Membership rates for the club are significantly lower than comparable programs in the area. The program includes a house-league(novice)stream as well as a travelling competitive steam(approx.a 50150 split within the membership). The season runs from 9 to 11 months of the year depending on level of participation. Training groups are divided by age and ability and split between morning and afternoon sessions in two different pools. Children involved in the club have access to a near year round program that provides an encouraging environment,with positive interaction with adult leaders. Swimmers develop many important life skills such as goal setting and time management through participation. The club also has a recognition program encouraging academic achievement as well as athletic. Of course they also benefit from increased physical fitness,with both immediate and long-term health implications. Please find attached a copy of club goals,an introduction to novice swimming,training group descriptions, and a fee schedule showing program rates and obligations. APPLICATION x(11 O.brlo 1 ottery Coryonlloe jodeli der 101"1"di I'Oebdo lorosrcralimsuile©oo Please see attached page of instructions. Sarll SIC.Manc.onrario P6A6V2 - Please print or type - 1. Previous charitable gaming licence FOR ' • Has your organization ever applied for a charitable gaming even(licence? No Yes(11 yes) _ N What is the most recent licence number issued by: AGGO: s P Municipality: Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? 9No Yes 2. Information on organization !:`1 4 � GIN C a) Incorporated or legal name l� ����c_l, �, I _0V Nrw) Fclay-A Street address of orga ization I city Province _– Postal Code N I T(e'�lephone No. 3 i � /Qfax(t�u.5 r ^r C)'s, a ,v 1 LA r1 1 I lh�— 1 I 1 I \ t– _ I 1 1131 — Imo(JI I, I Mailing address(il diftererl) I Postal Code I I �b) Is your organi,2tion incorporated as a non-profit organ'uAtion? No s(It yes) Jurisdiction of Incorporation:.;,mbar Incorporation c) Is yo,x organ,i---.lion registered as a Charitable Organization with Revenue Canada? Ci No 9Yes (11 yes) ? 1 0 '2 G Revenue Canada Reg.number I I I I I I I I i I I d) Hov,long Nas your organization existed? What is the financial end of your organization Month Day Years 3. Affiliates I Is your organization affiliated with any corporation or organization? t No Ye s I(yes: L isl the legal Names(A7:nh separate sheel it necessary) a) b) I 4. Use of net proceeds QQ© What will the advance funds be used for?(Allachseparatesheel ilnecessary) 2) jpr V-1C1A(7:�: %A kA b) -�UCL& nQAZ .\04\ Questions? C,.:11-600-387-0098 CAP ool COnbnueC.Gut 00c: 5. Lottery trust account .... :,. , Name of financial Institution W'here lottery funds are held Account number 000 i7 zz 3 j Address / City G. Unorganized Areas Is your Charitable organization located in an unorganized area? [�No n Yes (//yes,please indicate) [j ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED F] THUNDER BAYUNORGANIZED NIPISSING UNORGANIZED ❑ TIMISKAMING�NORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from t dvance funding. • I/we have been authorized to make this application on behalf of organization. • I/we agree to deposit all advance funding into the designated I trust account. • I/we agree to use the advance funding for approved charitable ses only. • All answers provided in this Application,as well as all the infor n contained in the documents and materials submitted with it are true and complete. We have read and understand the a Declaration above. Principal Officer Princi al Officer Signature -Print name in f `Title - c e c�-c r- Business telephone er; I(o31310 <•• Oa* te Signin -:' 9d 2 Providing inaccurate information may render your o tion ineligible for advanl.e funding Questi�ns? ,I t o.: �i 0098 Ce tOrmu!cu= �_ cusstClr,,-ten;ore en/rcnrois. DurhEIM East 4-H Association is z.j youth organization the primary purpose of this organization being the personal development of youth in rural and urban Ontario specifically Durham East .The 4-H programme is open to young people 10-21 years of age .Locally run clubs are planned to suit the needs in each community of Durham East ,Projects include livest(Dck, iii-itritioii, fitness,cr,=tft-- to name a few.Parents and public minded citizens serve as volunteer leaders and advisors -Our well planned programmes in Durham East strive to provide effective training and experience in technical knowledge,assuming responsibility,co-operation with others .conducting business meetings, constructive recreation and programme planning -Character development, good citizenship and training in leadership,agriculture and life skills are important goals of the 4-H programme in Durham East . Some of our specific activities are judging coaching and competition .achievement programmes,Go for the Cold competitions,youth rallys,as well as individual club activities .We work hard to develop an interesting and worthwhile programme for our youth as we continue to uphold the 4-H motto "LEARN TO DO BY DOING" APPLICATION #12 : I r..... O.Irrlo larlery earya.11a. soueu e.r rol.rl.r e.ro.r.lo to Foster01il2.Suitt!s00 Please see attached page of instructions. SaJll Ste.Marie,Ontario P6a6v2 — Please print or type — 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? a No Yes(Ilyes) What is the most recent licence number issued by: AGCO: P Municipality: Have you had gaming event licences cancelled or licensing 2<o Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name ll/>l lV Co 111411V ry CINr�C SSttreet address of organization � � City / Province C�'n c . //./"y Postal Code j� Telephone No. Fax No. Mailing address(ildil;: Postal Code rerfJ 7Z62 .-Ld C' SCcC<�ir 11000 ,c h lS '/1 1 ONE 140411, 16 b) Is your organization incorporated a anon prctit organisation? [g<o Yes(11 yes) ! Jurisdiction of Incorporation number I Incorporation c) Is voou�ur'orgy niLation registered as a Charitable Organization with Revenue Canada? CVfN0 Yes(1l yes) i Revenue Canada Reg number I d) How long has your organization existed? What is the financial yzr end of your organization I Dec f nth I D ay Years � (,! r!1�J 3. Affiliates Is your organization affiliated with any corporation or organization? [L No Yes 11 yes: List the legal Names(Aianh separate slheiel it necessary) z) b) 4. Use of net proceeds What will the advance funds be used tor?(AllachsVaralesheelitneassary) a) ` (✓t1 GtY (�lG�'. 44(1 'i -h b) C) i 11SG(�c21 �In d)�1�`tirlf�tl�t.rli'e i� 5 Ouestions? C,.tI 1-800-387-0098 Continue;can tbOCk O.0 CAP 001(—,'.9s) ''. 5. Lottery trust.account ... Name of Ilnanclal Institution where lottery funds are held Account number Address City G. Unorganized Areas Is your Charitable organization located in an unorganized area? [;KO ❑Yes (If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • 1/we agree to use the advance funding for approved charitable purposes only. • All ans%•+ers provided in this Application,as well as all the information contained in the documents and materials submitted with i; are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature ;, = C/ ws :Print namefntull.F rile — Business telephone number; c c qal � � Ilw — I� Esc, cG�I� I � t�t31 — Il�tsl01 � •Oats Si.ping: • * { Providing inaccurate information may render your organization ineligible for dvant:e funding Questions? Ca t•800-3.&:-0098 Ce formu!cir2 es, cusst cosponiVe en franGois. pHaydon Community Centre c/o Lynne Piggott 7762 Old Scugog Road Enniskillen Ontario , LOB 1J0 Marie Knight 40 Temperance Street Bowmanville Ontario , L1C 3A6 November 20 , 1998 Dear Marie �X tlunity centre 1 am appi:'inR for an Ontario Lottery Corporation grant to help fund the centre . 1 ) The furnace and duct work at the centre is ancient and needs to be replaced , The majority of the money we receive via our fundraising projects goes to heat the building . 2 ) The building was built as a schoolhouse , S . S . 1121 Darlington , in 1876 . The windows are probably the originals and leak like a sieve . They need to be replaced , 3) The ceiling was lowered and the walls were covered half-way up with varnis >d plywood but no insulation was added to preserve the heat in ei her area . 4) The roof needs to be replaced and the extremely worn material on the floor in the main area of the centre is the original floor covering . it also needs to be replaced and the floor insulated . The chairs are chipped and catch on to and leave pulls in clothing and the legs of some tables need to be replaced , The playground equipment needs to be repaired and/or replaced and more items could be added to compliment those already present . The benefits provided by the centre are : a place for the members of "Club 21 " to hold meetings and community events , a focal point to meld the community together and provide Haydon with an identity , a place to hold fundraising events so that the hall can be maintained and charities can benefit from a portion of the proceeds , another income source by renting out the centre , a place for serving a funeral luncheon to the families of fellows/affiliates of the community or those who are celebrating anniversary/birthday milestones , and a place to gather foodstuffs and other items for a food bank . The building and grounds are kept in good repair by the custodian and the members . The Municipality of Carrington provides some assistance with regards to minor repairs etc . (Fred Horvath) , and pays the taxes and insurance , Haydon Community Centre - 2 - The centre does not have an assigned operating budget . The funds that are accrued during the previous and current .years ( from the fundraisings , rentals , and donations , plus a small mutual fund investment) minus expenses are those which the centre uses to operate . The numbers of members is diminishing as their ages are advancing . New members are slowly being recruited so that we will have new ideas for fundraising and a wider base of volunteers to draw upon. The older members are getting tired of working diligently for long hours only to see their efforts literally "go up in smoke" (up the chimney in heating costs ) . Some of the members actually attended school in this building and one member taught school here . You can certainly understand that the nostalgic sentiment regarding the centre runs high in this group . When the school was closed, they applied for and were granted permission to use it as a community centre . The members are hopeful that ou will award a substantial grant so that the centre can remain o;° en for the sake of the community . Please find enclosed the application form, a list of the board members , a list of the members , the original bank account statements for 1997 , and the statements of account for the mutual fund investment for 1997 . Sincerely yours Lynne Piggott (Mrs . ) Treasurer Haydon Community Centre Enclosures APPLICATION #13 Unto Lofty Corpors0os SOC/dn der loledss de V081odo 70 foster Drive,Suite 800 Please see attached page of instructions. Sault Ste.Marie,Ontario P6A6V2 - Please print or type - 1. Previous charitable gaming licence • - • • Has your organization ever applied for a charitable gaming event licence? No 0 Yes(If yes) What is the most recent licence number issued by: AGGO- P Municipality: M 4 P S k X102. Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? ©No Yes 2. Information on organization GIN a) Incorporated or legal name D v Ju Street address of organization City Province Postal Code Telephone No. Fax No. D D ( 9 1 p _) & I/- Mailing address(ifdi//erent) Postal Code b) Is your organization incorporated as a non-profit organization? ❑No FX�Yes(If yes) Jurisdiction of Incorporation number lf.Q/ $ j$ I Incorporation y N 71-1,4 D c) Is your organization registered as a Charitable Organization with Revenue Canada? 7 No ®Yes(If yes) I Revenue Canada Reg number 01 `NI Iyl3 I ?IOIS 161 / I�.I d) How long has your organization existed? What is the financial year end of your organization Years y�c7 yR `7'/ti�D/f ��/�g7�ti/� �� 0 9' ag Month Day /7r �l+ 3. Aff iliates Is your organization affiliated with any corporation or organization? ®No ❑Yes If yes: List the legal Names(Attach separate sheet if necessary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheetifnecessary) a)1 12,0)7/0W 'TD /pAd$III T /7/t/'liL{� b) Vik� 116601h?4Nl1w6- 4 15 7-J"4,2>� °) d) Questions? Call 1-800-387-0098 OLC CAP 001(98/05) Continued on back i 5. Lottery trust account Name of financial institution where lottery funds are held Account number 04 I tv T m :R/L xis( - Co it,ol j= c - 7106, o / Address city 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ❑No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZE[1- ❑ KENORA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization, • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature. Print name in full Title Business telephone number y 5 f. Date Signing l / o Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponible en frongois. October 20, 1998 Municipality of Clarington Clerk's Department 40 Temperance Street Bowmanville, Ontario L 1 C 3A6 RE: GRANT APPLICATION We, the members of the Orono Athletic Association, are requesting a grant in the sum of $50,000.00 to help assist with the expansion of the Orono Arena and Community Centre. In 1997 Bel-Con Engineering Ltd. Submitted blueprints for the expansion with an estimated cost of $210,000.00. Since this project is planned to break ground in the spring of 1999, a 10% increase in the initial cost is anticipated. Therefore, the total cost to complete the desired and much needed expansion is $230,000.00. We have enclosed all the required data to support our request. As you are aware, the village and area residents have, in the past and will continue in the future, contribute, the bulk of the funds required. This fund request represents 21.7% of the total estimated amount and is certainly deemed a reasonable request. Sincerely, Orono Athletic Association I I i Orono Amateur Athletic Association "Incorporated" P.O. Box 165, Orono, Ontario LOB IMO Our primary object is the promotion of amateur sports and recreation for over 600 youth of the community. The accompanying letter explains the need for an addition to our present facility. You will note that our responsibility under the purpose and objects section of our Letters Patent is also to do things that are conducive towards accomplishing those goals. If we receive a grant the funds will be used to help us attain this goal. Amaim AWE& Assocklm-1 P.O. BOX 165, ORONO, ONTARIO LOB-1 MO Place Date Here Corporate Name and Address Dear Friend of the Community; The Orono Amateur Athletic Association's recent hockey registration, has shown a ten per cent growth in the number of players. A similar growth in figure skating has occurred. This growth in usership has many positive benefits for our community. Keeping our youth involved in sports makes for a pleasant and safer community. This increase has begun to put a strain on our existing building. More skaters and hockey players, more female membership on rely and house league teams and an ice surface that is very rarely if ever left empty requires the expansion of the support facilities. At a recent meeting of the Orono Amateur Athletic Association, it was decided that two more dressing rooms, more equipment storage and a multipurpose room are required to keep up with the present growth. Two new hockey teams will require storage space for equipment and sweaters. Eighty to ninety Can-Skate youngstersand female team members require more change room space. Parents, teams, officials, coaches, committees, Fair Board members and the Association require a room separate from the busy community hall to meet for a variety of reasons such as safety instruction, planning and other presentations. This addition will require a capital expenditure of approximately $ 210 000 . We would prevail upon your generosity in asking that you make a pledge to support the building. Once we have $100 000 in pledges, we will break ground on the construction. All donations are tax deductable and sizeable donations will be recognized in an appropriate manner in the new addition. We would be most appreciative of your assistance and look forward to your support. i Sincerely, Ray ster, President, The Orono Amateur Athletic Association ( 905-983-5584 ) I i APPLICATION X14 O.bd.rangy Ccrpcnla. sale!s..roads a 1,04.10 R0 rostet06W.suire 800 Please see attached page of instructions. C�rl Ste.Manic,ontario PcAcvz – Please print or type – 1. Previous charitable gaming licence FOR ' ' Has your organization ever applied for a charitable gaming event licence? No 0Yes (11yes) flf�" What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing AN' o F]Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name i Av op o m r9l'/t/ � i Ireet address of organization ! City Province Postal Code Telephone No. Fax No. Mailing address(if dilfererl) Postal Code 4IY7C i NT R7v lill C 1 b) Is your organization incorporated as a non-profit organization? MNo Ej Yes(l!yes) i Jurisdicli n of Incorporation r.urnber I Incorporation c) Is our orgyni_. istered as a Charitable Organization v:ith Revenue Canada? 0!No es (dyes) ( Revenue Canada Reg.number d) Hoar long hKs your organization existed? What is the financial y 1,end of your organization Month Daayy –>H Years ,1� �. ���N� I - 3. Affiliates Is your oreanization affiliated with any corporation or organization? No Yes 11 yes: List the legal Names(Att2a4 separate sheet it necessary) a) D 1/FiZ N 16 i2/I�f�T Iy/\11y' b) y-- 4. Use of net proceeds 11p�j t`1TCC �►=���17. �.7��� What will the advance funds be used tor?(Attach separate sheet itnecessary) a) m/ly lyIl 1,19 < b) .7J/sf)8zt D ��NlLt7/P�� C) d) C��l[JS X'!{c L L G71!/!JL s (F) r cld Sith�/C >%2 Sc`lri�eeL /�r"ADC/)l Questions? Cali 1-800-387-0098 Confin;�on boc� r..c:1,00 l rzo�r 5. Lottery trust.account ._.. Name of financial Institution where lottery funds are held Account Dumber 1 Address city 6. Unorganized Areas Is Charitable organization located in an unorganized area? No ❑Yes (If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED Q COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAYUNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of fie organization. • I/we agree to deposit all advance funding into the designated lorry trust account. • I/we agree to use the advance funding for approved charitable Oposes only. • All answers provided in this Application,as well as all the informilion contained in the documents and materials submitted with it are true and complete. We have read and understand the enfre Declaration above. Principal Officer Principal Officer signature r 61C& -Printname t - - -. �� In t 6fJ✓� .�' Title PR O S i n c V�T / It✓ �J (� I�I i — I rJ 17 I I T Business telephone A�m6ere N s Signin gi•Oat . Providing inaccurate information may render your 01 nization ineligible for advantie funding Quesncns? Ca„ !-800-3-S17-0098 Ce lormu!cir=e_v cuss,djsccno 6.'e en fronrois. APPLICATION #15 Oobd.l otlery Corpo.alo. 0WON 011101.da d,l�O,d.do 4 J D(� n 10roslcrork.Suitep00 Please see attached page of instructions. 2 �I 1 (f '!'� Sall Sle.Manic.Ontario rca�vz - Please print or type - 1. Previous charitable gaming licence FOR OFFICE-USE'ONLY: Has your organization ever applied for a charitable gaming event licence? u No ZYes Ill yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name SC ire R oary►rna10 rTy ��N7��' 1�ct+rt 'D. Street address of organization ! City Province, 7 CoNe.e SS /�,.,� Jf u L^ AInl- !D/✓ o Postal Code Telephone No. Fax No. LI0I13L1 � 10 1` 1b1 1 — IQ 1(-- Itil 1016 1 Ix I - 1 � 1 1 ' � 1 Mailing address(il dillererl) I Postal Code I I I b) Is your organiJnfion incorporated as a non-profit organisation? DNo �Yes(11 yes) Jurisdiction of Incorporation r Aber Incorporation c) Is your orga;:_.lion registered as a Charitable Organization with Revenue Canada? CNo Yes (!7 yes) 1 Revenue Canada Reg.number d) Ho-.-j long has your organization existed? What is the linandat tier end of your organization Month I 3 ay Years v! 5-L� , o��o j 9� / / 3. Affiliates Is your orcZnization affiliated with any corporation or organization? N o Yes 1t yes: List the legal Names(APtaah separate sheet it necessary) z! b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet it necessary) .��tvv „r Q�IF-ST M � v�`'r()c aI /72k �mP�ot��l�lFti rs ((P�,en ocS b) cl /��� /N�l �a i d) Oueslions? C_=:I1-800-387-0098 :CAPOO1 ,- . , Con fin;_n;on boCl 5. Lottery trust account Name of financial Institution where lottery funds are held Account number 1 Address city G. Unorganized Areas Is your Charitable organization located in an unorganized area? ONO Yes (It yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED "COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAYUNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We. the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of#ie organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application.as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. r Principal Officer Principal Officer Signature i p -Print name in full ,.Title C N II l f e r2 S c nJ r<C���i rl i2 y E/�S Business telephone number; l U I S 113 I I !d l� I I G • Oate L Providing inaccurate information may render your organization ineligible for advance funding Queslr-,as? Call 1-800-3s-1 -0098 Ce tormu!cire�_;;Cussr Urs,pon.-ve en franc ors. SOLINA COMMUNITY CENTRE BOARD C/O DEANNA MACDUFF 1914 CONCESSION RD. SIX HAMPTON, ON LOB 1J0 November 20, 1998. Municipality of Clarington Clerk's-Department- Re: Ontario Lottery—Advance Funding Board of Directors Chair person - Herb Tink Vice Chair - Karen Dair Secretary/Treasurer Deanna MacDuff Two members from each of Recreation, Park and Hall Committees. These members rotate on occasion. We have several activities in our community. The park is used for lobball, softball,and soccer. This.summer,we had 3 children's ball teams, 3 men's teams, and 3 ladies teams. We also had 5 children's soccer teams, and 2 adult teams. We presently have 2 ball diamonds,and a soccer pitch which can only be used when there is no baseball on the second diamond. This basically eliminates practice time,because of the shared area. We also have a tennis court,and basketball net, and a children's playground. We own more land at the back of our park. What we face now, is whether we should try to develop this land, or go to flood lights for our ball diamond. Our community has tripled over the last 10 years,and a new subdivision is presently being built. We feel that it will be very difficult to accommodate more children without having a dedicated soccer pitch. Another local organization has discontinued their soccer activities,and several children from this area are now coming to Solina for their sports. We would like to put flood lights around 1 diamond,which would allow us to have 2 games a night on this diamond, and this would then give us a dedicated soccer pitch during the week, and the two diamonds for weekend tournaments. The cost for this will be in excess of$100,000.00. Also,we have a fence that needs to be replaced. To do this with a good quality chain link fence, it would cost us another$9000.00. Our hall serves all age groups in our community. The hall is presently being used for 4H, cubs,and W1 meetings, all without cost to them. We also have a seniors organization,the Silver Set,which accommodates these people for meetings,and luncheons. This is a very active group as well. Also, it is used occasionally by our Church,for Christmas concerts, and Vacation Bible School in the summer. This event was extremely well attended by children in and around our community. There are also card nights on Fridays during the winter months. Our hall is handicapped accessible. Three years ago,we put in an elevator for the use of people who are physically challenged. This has allowed many of our local people to once again attend functions at our hall,where they were previously shut out. The hall is rented out for dances, showers, and weddings. The banquets are all prepared and served by volunteers. This allows us to make money to basically cover running expenses for our hall. Our hall now needs to have the parking lot repaired, We have-been-checking.out,prices for this,and it appears that we can have half the lot done with recycled asphalt for approximatley $12,000.00. This quote will have to be verified in the spring. Both of these projects will be major expenditures,which will require assistance. In order to complete this work,we are requesting funding for$125,000.00. Thank you for considering our organization for advance funding for these projects. Sincerely CM Deanna MacDuff. Secretary/Treasurer. Datg:95 J ��Jn-c Time To ty"DcbIL,�— WRE UT WILE YOU E From Company 'v �`-j Ar+s 3 Teleph one Fax PN MESSAGE ec J cratorl", ,NE A1661-� 7?-U 6 0e1doLotterCorponao. APPLICATION #16 soditi Fort r rive,Suit/800 Please see attached page of instructions, 70 Foster Drive,Suite 800 p g Sault Ste.Marie,Ontario P6A6 V2 - Please print or type - 1. Previous charitable gaming licence FOR OFFICE Has your organizatio ever applied for a charitable gaming event licence? No Ns(If yes) 4_0ew_��, What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing No Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name ,Ij_� �/,�Url &7� Street address of organization City Province / �3 ,siwg kj 4 y/, � Postal Code f Telephone No. Fax No. LlC 1 � (91 10 5) (0X Is-'] 3I ( 05) 1 _ 0 7 Mailing address(it different) Postal Code Imo � Kg b) Is your organization incorporajQd as a non-profit organization? []No �s(If yes) S-3 5 19 Jurisdiction of Incorporation number Incorporation c) Is your organization registered as a Charitable Organization with Revenue Can ad ? �� 3z No Yes(If yes) �9 Li Revenue Canada Reg,number I I I I I I I I I I I d) How long has your organization existed? What is the financial year end of your organization h I -31 Years 3. Affiliates Is your organization affiliated with any corporation or organization? Wo VYes If yes: List the legal Names(Attach separate sheet if necessary) G� ZC.liLK ' u�t'�-�l / I SS 0 ` /`sy-T (�1P.{.�OA/O� a) FJ b) Om2k� 4. Use of net proceeds 64-rmJ What will the advance funds be used for?(Attach separate sheetifnecessary) Cie b"0 .t,--fl a) b) Questions? Call 1-800-387-0098 S� � �S _ OLC CAP 001(98105) , � Continued on bock 5. Lottery trust.account Name of financial institution where lottery funds are held Account number Tss _ City bey C ��tv� 40 6. Unorganized Areas Is your Charitable organization located in an unorganized area? No ❑Yes(If yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. Alai • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. A / Principal Officer Principal Officer J (( �V,/�/ Signature Print name in full MAR ET ROD& X AA foQ DIRECTbit q ` 2 Butinest telephone number 911115) d d Zq e Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponible en frongais. Curriculum Connections (Educational Outreach) pARTners PURPOSE: to provide links between community groups, the municipality, and local schools • building positive relations between schools and community • encouraging community pride and involvement among students, teachers, and the greater public • improving the quality of life in the community • arts advocacy in the community Projects include: • Art in the Atrium -the creation of two temporary hanging installations in the Courtice Complex (following the successful Fish Project); • Anti-bullying Project -Auntie Violet's Decision (for 25 schools)Picture-story presentation with music plus artists' workshops.; • Dance project with Bowmanville High School and elementary schools- Dancing the Science Curriculum Senior dance students from Bowmanville High School lead workshops in Plants/Animals(Gr 2-3) and Energy/Control (Gr 5-6). BUDGET INFORMATION Art in the Atrium (costs for each of two projects) Expense Items Expense Projected Revenue AMT Revenue AMT Sources Artist/instructor $1200 Lions Club $750 ($150 per diem, 8 days in school) Materials from $300 Schools $300 school Materials $150 OLC $750 (beyond school supplies) Coordinators $100 (Educational Consultant& VAC) Total $1800 $1800 Anti-bullying (visual artist, storyteller, musician) Expense Items Expense Projected Revenue AMT Revenue AMT Sources Artists Fees for 7500 VAC studio use 200 25 class visits (in kind) Coordination 300 School& 200 artist's supplies (in kind) Supplies 200 Optimist Club 3900 Rehearsal space 200 OLC 3900 Total expenses 8200 JTotal receipts 8200 Dance Project: 10 sessions @$100 =$1000 Total funds requested from OLC for pARTners projects: $6400 Ri,ercairii by Rowena Dykins purchase price: $5000 from exhibition at the Visual Arts Centre, April 19 - June 5 1998 The water of Soper Creek,which winds its way past the Cream of Barley-Mill-5-is-a major element in several works in The Real Mackay exhibition, most directly in Dykins' white cedar construction RNercairtt. Its patterned surface emulates the movement of waters that meander or rage past, depending upon the season. A five by seven-foot beehive shape, it speaks for its antecedents: cairns were burial mounds, storage devices, markers and focal points for ritual activity, sometimes related to astronomical phenomena and the changing seasons. In Greece they became road markers, symbols of Hermes the messenger who took dead souls to the underworld, —the god of travel and patron of travelers. As architecture developed towards the use of timber framing, sections were enjoined with doweled components, and cairns were carved and decorated. Dykins is working within this tradition, using a doweled construction, and incising water current patterns on the lower exterior. For Dykins, whose ancestry is Welsh, cairns are personal reference points for identity, reminders of past travels, and an ongoing element of her artistic practice. In A Lost Tradition: The Nattn-e of'Archilecluu•e in IL-eland, Niall McCullough and Valerie Mulvin point out that the circle is common to many primitive societies, used in the construction of huts and the delineation of an enclosure for ritual, defensive or domestic use. It is at once the most economic and the most perfect of forms . . . naturally emulative of the sun, the moon, and the pattern of the seasons. . . . complete and unassailable at any scale. ' Their description of certain burial mounds in Ireland as "ordered and centralized, . . . secret and without access - closed" aptly describes RNercairn, mute, massive and in its simplicity, a tabula rasa for contemplating the passing waters, a marker for recollections of other markers, a mystical piece that elicits its own aesthetic force field. `' Rivet•cail,n connects to other pasts and mythologies, with the notion of ongoing movement, flow, and change, and in the sense that Rivercair•n represents the furthest reaches of memory and record within the context of the exhibition, it can read as marker for the rest of the show. As a long-term installation, it would make a stunning addition to Soper Creek Park. Endnotes 1. Niall McCullough, and Valerie Mulvin, A Lost Tradition: 7%e Nalum of Archilectttr•e in Ireland(Dublin: Gandon, 1987) 17.. 2. Ibid. Staffing Upgrade Marketing, promotion; and special events coordinator 10 hrs per week @ $10 per hr. For 20 weeks = $2000.00 Galleiy Improvement __Vestibule-carpet: Room darkening blinds for daylight slide/film presentations: Quote from Restorama $852.79 Visual Arts Centre of Clarington Staff List Curator Director: Margaret Rodgers fill time Administrative Assistant: Linda Ward permanent part time Bookkeeper: Deanna MacDuff, Administrative Office Services independent contract Art Rental Consultant: Irene Lubowitz commission Curriculum Connections Liaison: Anna Luckai commission r �7 oendo LoOery c«v«e0oe APPLICATION #17 sociN d"Id Mee de 110e11lo 70 Foster Drim Suite 800 Please see attached page of instructions, Sault Ste.Marie,Ontario P6A6V2 - Please print or type 1. Previous charitable gaming licence • - OFFICE USE ONLY: Has your organization ever applied for a charitable gaming event licence? _yNo F�Yes(If yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing D No ❑Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name :Jor,l Street address of organization City Province ds1:f ey 0 r Postal Code Telephone No. Fax No. i K5 ( '� D � ) 5 ') _ r � � ( `� 5 ) 5� (�� _ X33 Mailing address(i(different) Postal Code b) Is your organization incorporated as a non-profit organization? No n Yes(If yes) L Jurisdiction of Incorporation number I Incorporation c) is your organization registered as a Charitable Organization with Revenue Canada? c� No Yes(If yes) Revenue Canada Reg.number g I l y l I I I I I I I I d) How long has your organization existed? \ What is the financial year end of your organization lMonth Day Years 3. Affiliates Is your organization affiliated with any corporation or organization? No Yes If yes: List the legal Names(Attach separate sheet if necessary) G ��� ( � � c OyA 4. Use of net proceeds Q) p p p What will the advance funds be used for?(Attach separate sheet if necessary) k� 51��, o�C ;�. f vL�`e�rlr, b> ©C C- a) „ c)�ls�.'(S�l�q �•.�r�l'�- Al�l�;��r,—�-r �c��-�,��- r-e2z„t�u( o4m tl Questions? Call 1-800-387-0098 OLC CAP 001(ge/05) Continued on b= 5. Lottery trust account Name of financial institution where lottery funds are held Account number +1 ddress city ICI i �� t • ��� t Oska-wi. , Ji`J L I S 6. Unorganized Areas Is your Charitable organization located in an unorganized area? 7 No 7 Yes(If yes,please indicate) 7 ALGOMA UNORGANIZED F-� PARRY SOUND UNORGANIZED 7 COCHRANE UNORGANIZED 7 RAINY RIVER UNORGANIZED Q f<ENORA UNORGANtZEfi7 SUDBttRY-UNORGA"N1ZED MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED 7 TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature Print name in full Title Business telephone number 1;�- I l� 1--7 Date Signing q �� l Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponible en franGais. AlzheunQ, Alzheimer Society of Durham Region Oshawa Executive Centre Suite 205 419 King Street West Oshawa,ON LU 2K5 Bus. (905)576-2567 Fax.(905) 576-2033 November 26. 1998 Ms. Marie Knight Clerk's Department, Municipality of Clarington, 40 Temperance Street, Bowmanville, Ontario L1C 3A6 Dear Ms. Knight, Enclosed please find a budget breakdown for our request for funding available under the Advanced Funding Program of the Ontario Lottery Commission. Our total request for funding is for $10,000. 62 families in Clarington utilized Durham Alzheimer Society services in the past year. This represented 20% of our caseload. Of these,33 are currently active. An additional 25 persons from Clarington also requested information packages from the Society. Also enclosed is a cheque for $25.00 for processing our application. Thank you for your assistance with our application. Sincerely, Brenda McConnell encl. u r h a Alzheimer Society of Durham Region Funding Request-Budget Advanced Funding Program - Ontario Lottery Commission Item Amount Support Services Expansion • establishment of a satellite office • establishment of a support group for caregivers • promotion/advertising • honourarium for space utilized • staff/volunteer expenses-travel, salaries, training • telephone expenses • program supplies $9500.00 Establishment of Portable Library Program • purchase of contents: -books, videos, pamphlets, 500.00 Total request: $10,000.00 1 ?8 =..:P1 ill 3C 93-1'33 . X33 -003. 70S APPLICATION 418 .'p • • JaCrY L���aw� Plecsa sea ortcched page or instructions. ,Q laver u;.a Srcier a� r X47 - Please print - type 1. Previous charitable gaming licence • ' ° • i-as your^:7anlnftn ever apptied for a cnartable garrong went licence? ❑No Yes(tires) What is the most recent licanca,^umber=sued 5y: January 28, 191 8 AGCO: P P980550 Municipa&ty: M Have you had gaming event licences cancefted or IicertwnQ privileges suscended in any juridication in the last two(2)years? Q Yes No �-} I 2 information on organLmMion GIN a) Incorporated or 1490 name ALTTI&M SOCIETY CNEARIO Durham Regional Chapter Al S I HI 0 f3 i 5; 8 Street address of oroaniaanon city Province 1 Greensboro Dr. Suite 306 Etobicoke ON Postal Coca Telephone No. Fax No. 246-9417 Ml 91 W j 11 _CI 8 (416 246-915921 1 1 11 4�2 I- ) I I — I I t Mailing address(il Oft") I 1 Postal Code II i b) Is your organizaian incorporated as a non-aratii Ott aairation? 7 NO ®Yes(//yes) i lunsoiccon of IncorooraUon number 271183 Incoraoration CNrARIO c) Is your organization registered as a Charitabie OrpaniMUen with Revenue Canada? No Yes(Dyes) Reveme Canada Reg.number 0 1 4 1 11 5 1 4 r 61 3 I —1 1 1 1, t 1) How long has your organization existea? What is the financial year end of your organization Month Day Years 25 years I 3 . 131 3. Affiliates Is your organizatian affiliated with any corporation or organization? DNo 7 Yes i/yes: Lisl the loge!NaneS(Atidtn ?Canfa=nee!;7 n;cessary) a) b) 4. Use of net proceeds What wilt to advance funds be used far?('A a=separate snaw it neeassary) a) Members Services Manager b) See attached C) d) Duesdoas? Call 1-800-387-0096 ac ctia 00 t(saps) corn'rLac cn bcck S. Latter/trust account Name of tiranew institudcn wnere iutery tunas err M.d Account number 1002120 FOYAL BANK. OF CANADA redress �city 8185 Yonge Street Thornhill Ontario 6. Unorganized Areas is your C rentable orraniration located in an unorlanized area? c�No I Yes("Yes,ply'irad,�rate) ( ALGOMA--UNORGANIZED 17 PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED Q KENDRA UNORGANIZED ;L] SUDBURY UNORGANIZED E' MANITOULIN UNORGANIZED C THUNDER SAY UNORGANIZED Q NIPISSING UNORGANIZED ; TIMISKAMING UNORGANIZED 7. Deciaration We, the undersigned,declare that: • 11we are a Principal Officer of this organization. • Itwe are NOT receiving remuneration direc,�/or indirectly from the advance funding. • lAve have been authorized to make this application on behalf of the organization. • INve agree to deposit all advance funding into the designated lottery trust account. • lhve agree to use the advance funding for approved c iaritable purposes only. • ipwe will sponsor table game events at the local c.-%arity casino. • All answers provided in this ApplicatIM as well as alt the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal officer �)J&q Signature � Print name in full Vernon Georg �$haP Sarrniel Chair, Fundraising 5=ittee Title Board Member Office Manager Business telephone number, ( 4 11 1 6 ) 21 4 61 — 19 1 519x2 (4 ' 11 R) 214161 - 19 151912. September 16 , 1998 03tesign.1ng September Providing inaccurate intormation may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ca,'prmutcire esr Cussi disNor c;2 gh %C^ s. I GREENSBORO DRIVE.,SUITE 306,TORONTO,ON M9W I C8 • BUS: (416) 246-9592 • FAX:(416) 246-9417 E-MAIL:audsmon@passport.ca �"ARFAB REGISTRATION NO.0415463-11 �� 13 October 30, 1998 The Clerk Municipality of Clarington 40 Temperance Street Bowmanville, Ontario L1C 3A6 Dear Sir or Madam: Please find enclosed Autism Society Ontario's Charitable Roster Application - Advanced Funding and supporting documentation. Autism Society Ontario is a not-for-profit corporation registered in the Province of Ontario and a Registered Canadian Charity. The Society operates self-help groups in which parents of children with autism provide community-based support, information and services to those with autism, their families and educational institutions and decision makers. The work and activities of the 25 Regional Chapters are supported by a small provincial staff. The purpose of the application addresses the need for financial support for the Member Services Manager who is pivotal to the work of the Regional Chapters. An Executive Summary Position Description has been included for your information. The Durham Regional Chapter meets monthly to provide education and information workshops. The Chapter supports children and adults with autism and their families. This past summer children with autism attended Scott's Place. Additionally, ASO Durham Regional Chapter hired two students with the assistance of a federal government grant and provided an adult/adolescent summer program and respite and time-out opportunities for families with young children. i HONORARY PATRON:THE HONOURABLE HILARY WESTON, LIEUTENANT GOVERNOR OF ONTARIO -2- ASO does not receive grants or purchase of service funding from any level of government nor are we members of any local or regional United Way campaigns. Your assistance in helping ASO to defray some of the costs of services and support provided to persons living with autism in your community would be deeply appreciated and we look forward to working with you to enhance the quality of life today and, give hope for tomorrow for persons with autism and their families. Sincerely, T.C.B. Williams Executive Director encl. C.C. Lyn Kyneston President Durham Regional Chapter I GREENSBORO DRIVE.,SUITE 306,TORONTO,ON M9W I C3 BUS: (416) 246-9592 • FAX:(416) 246-9417 E-MAIL:autismon @passporcca Noy �S CHARITABLE REGISTRATION NO.0415463-11 rr 12 s8 P17 '98 November 23, 1998 Ms. Marie P. Knight Municipality of Clarington 40 Temperance Street Bowmanville, Ontario L1C 3A6 Dear Ms. Knight: Further to your letter of November 6, 1998 Please find attached: 1) Executive Summary of a position description for a Member Services and Chapter Develpment Program; 2)the processing fee; The Durham Regional Chapter supports persons with autism and their families living throughout the Region. Special Education Advisory Committee representatives serve on every Board of Education in the region. The representatives advise the board on issues related to the care and instruction of children with autism. There are families living in Bowmanville with children with autism. The nature and extent of the support for each family varies depending on their needs. The Regional Chapter provides a summer camp program and has been successful in acquiring funds to provide respite care. The operating costs for the member Services and Capter Development Program is projected in excess of$105,000 per year. Autism Society Ontario would ask that the municipality consider assisting ASO to offset the costs to whatever level you are able. Any contribution, regardless of the amount will be directly applied to the program. I hope these comments are of assistance. Sincerely, T . Williams ecutive Director HONORARY PATRON:THE HONOURABLE HILARY WESTON, LIEUTENANT GOVERNOR OF ONTARIO A U `T 1 S M E GREENSBORO CRIVE..SUITE 306.70RONT0.ON M9W Ics BUS:(416) 246 9592' FAX.(4E6)246.9417 ' :E MAiL auusrnon @passporc ca CHARITABLE REGiS1'RATIC?h�t t`tO.f14t5463.E f Executive Sa;nfnary ltlem ' er Services and C;iapter Development Prnaram Member Services Manager The Member Services Manager is a pivotal staff position providing both individual services to children and adults with autism and their families and group development services to local groups of parents, service providers and decision makers. The Autism Society Ontario (ASO) has 25 community-based regional chapters and has set a target of establishing a further 20 chapters by the year 2001. The Member Services Manager: 1) manages the development and distribution of the Parent Education Package and provides direct support and consultation to parents 2) manages the development and distribution of a kit for teachers of children with special needs and provides direct consultation to teachers 3) develops a directory of local resources for Regional Chapter use 4) recruits, trains and manages the Special Education Advisory Committee (SEAC) volunteers and provide direct support for their work with 66 Boards of Education 5) recruits, trains and supports local volunteers and provides support for the development of Regional Chapters throughout Ontario 6) organizes and delivers education and training workshop to parents, educators and community decision makers The Need One in 500 children are born with autism and pervasive development disorders (pdd). The thousands of Ontario children with autism seek the opportunity to participate as fully as possible in society. Autism is a life-long condition, the need for early diagnosis and intervention, education and, in adulthood support and training is essential for ensuring an optimal quality of life for individuals with autism. The Member Services Manager plays a vital role in facilitating access to services, support and information to families and education and information to community resources. HONORARY PATRON:THE HONOURABLE HILARY WESTON, LIEUTENANT GOVERNOR OF ONTARIO -2- The.Autism �Vember Services and Chapter Development Program Annually: 1) creates, produces and d1Str:t"`tAC `P-rejt cation Packages' 2) creates and distributes a `Volunteer Handbook' 3) through the Provincial 'lot--line' provides information and referrals to community resources 4) develops and distributes a 'Directory of Local Services' 5) establishes liaison with government ministries and maintains a working relationship with these ministries to ensure effective communication and solutions to issues affecting individuals with autism 6) conducts regional chapter visits and volunteer leadership development sessions Program Budget (1) Member Services Manager Compensation $60,000 (2) Regional Chapter Site-Visits and Volunteer Leadership Development Training $ 7,500 (3) Presidents' Council Meetings $ 3,000 Semi-annual (Travel/Accommodation) (4) `Parent Education Packages' $ 2,500 (production & distribution) (5) `Volunteer Handbook' $ 2,500 (production & distribution) (6) `Directory of Local Services' $ 2,500 (production & distribution) (7) Administrative Support $ 15,000 (8) Operations Costs 12,100 Total $105,100 APPLICATION #19 O.nrlo lottery[oryonlloe Soddlddet loledu do I'Ost do 10FoslerOdw.5uile800 Please see attached page of instructions. S?ull Ste.Marie,Onlalio P6A6V2 - Please print or type - 1. Previous charitable gaming licence FOR OFFICE Has your organization ever applied for a charitable gaming event licence? No I v1 Tes(11yes) What is the most recent licence number issued by: AGCO: Municipality: M Have you had gaming event licences cancelled or licensing No Fj Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name / �� S/.5 %;L-,J c� C1-SVie=/ -�c'fit/i/�` -�'� �/i?.��TC Street address of organization city Province Postal Code Telephone No. ( fax No.. / (9 � -3 L� C> ( CC U t O I t la I I I I I I I Mailing address(if diKererl) I I Postal Code I I I I b) Is your organization incorporated as a non-profit organization? n No ZYes(11 yes) Jurisdiction of Incorporation number (r5 ��/(� Incorporation 1&12 c) Is your organization registered as a Charitable Organization with Revenue Canada? No [j]/Yes (!!}'cs) i Revenue Canada Reg number I V, I I I C I d) Hog long has your organization existed? What is the financial yz-:r end of your organization Month Day Years �� y,-r-!---/WS I -�f�>F/ —X- I 3. Affiliates PFMpL)1\)•T' Tl�vi-5-f �'�l • Is your organization ffiliated with any corporation or organization? No Yes 11 yes: List the legal Names(A'taah separate shee!it necessary) a) C s/ G•- 0 b) -1/�T •j/5S �,/G �Pn /9' 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet it necessary) a) b) C) d) Questions? Call 1-800-387-0098 Continued on bock OLC CAP 001(9?A5) 5. Lottery trust account Name of financial Institution where lottery fonds are held Account number D f�%•3'_..3(n 1��3y Address city 6. Unorganized Areas Is yo/or Charitable organization located in an unorganized area? 1 No ❑Yes (it yes,please indicate) ALGOMA UNORGANIZED F� PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED [:],,,RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature' -Print name in full :Title c Business telephone number- �' I •�— V 13 iU i(J (9 f Of J ) I —, IQ la Date Signing C18 Providing inaccurate information may render your organization ineligible for advam:e funding Questions? Call 1-800-367-0098 Ce formuloire e„cussi disponib!e en fn7nGois. Big Sisters Oshawa-Mitby-Clarington 555 Wentwori Registration#11880 9391 RR0001 Street East,# Oshawa,On, L1H 3V8 (905)725-930 Fax 725.856c October 27, 1998 u"te.evw� Municipality of Clarington 40 Temperance Street, Bowmanville, Ontario L1C 3A6 Re: Advance Funding Request $38,000. from Ontario Lottery Corporation Charitable Registration# 11880 9391 RR0001 Ontario Corporation# 659216 Dear Sir/Madam: Please consider our application for advance funding while perusing the attached documentation. Over the past year we have received a decrease in funding from United Way in the amount of $37, 672.00 (by the end of 1998). Our other funding initiatives - personal donations, nevada, and special events have also been steadily declining. Enclosed you will find a scale of the steady decline that we are experiencing.(Addendum#4) Big Sisters O.W.C. requests that the Municipality of Clarington consider a donation through the Lottery Corporation monies, in the amount of$38,000. to supplement the shortfall received from our United Way funding. This amount will enable us to go forth with our fundraising initiative (Addendum# 6) to ensure a more lucrative financial future. United Way has historically only funded direct programming of the Big and Little Sister Programme. All operating costs must be raised by the agency. Given the drastic decrease in revenue, the general operation of the agency will be at risk if alternatives are not found. There are currently no extra resources for promotions, and additional programming, which are an essential part of our operations. Our agency works proactively to provide advocacy and role-modelling to youth, empowering them to have control over their destiny, while contributing positively to the community in which Advance Funding Request (pg 2) they live. It is estimated to cost $95,000 per year to incarcerate one individual. Studies done in Washington State in 1998 have indicated that Big Sister/Big Brother and similar prevention programs can be attributed to a 20% decrease in the predicted number of criminal offenses occurring. Through the Ontario Lottery Corporation Advanced Funding_Initiative, it_is_our_hope_to_direct more funding directly to our secondary programs, as well as supporting the future initiatives as outlined at the Strategic Planning session. Big Sisters currently serves 14 Big Sisters and 13 Little Sisters in the Bowmanville area, 11 Big Sisters and 8 Little Sisters in the Courtice area, and 2 Big Sisters and 6 Little Sisters in the Newcastle area. We currently have 12 active volunteers in Bowmanville, 8 in Courtice, and 4 in Newcastle. At this time I would like to thank you for your consideration of our request. Attached please find additional information about our agency, as well as our 1997 audited statements and our to-date unaudited 1998 statements. Should you require any further information, or wish to make an onsite visit to our office, we would be happy to welcome you. Thanking you, J anne Howsam xecutive Director Big Sisters Sisters Oshawa-Whitby-Clarington � `-t,�� �( ��,( V a_ �L" � — Addendums 1. Big Sisters (What, Why and How) 2. 1997 Financial statements 3. 1998 Unaudited statements to August 1998 4. Revenue Graph 5. List of Board of Directors 6. Initiative#1 7. Charity Registration from Revenue Canada 8. Letters Patent, Bylaws APPLICATION #20 olisde LEN"cara.u" $00WN Iu 1004"N 1'06&* 70FoalerDrim,Suite 8W Please see attached page of instructions. Sault Ste.Marie,Ontario P6A6VP — Please print or type — 1. Previous charitable gaming licence OFFICE Has your organization ever applied for a charitable gaming event licence? ONLY: No Q Yes(It yes) What is the most recent licence number Issued-by: AGCO: P Municipality: -� 4 Have you had gaming event licences cancelled or licensing privileges suspended in any juddication In the last two(2)years? MNo [:]Yes 2. Information on organization GIN a) Incorporated or legal name Canadian Cystic Fibrosis Foundation - Durham Region Chapte C C H 0 4 6 4 Street address of organization City Province 181 Fallin brook Street Whitb ON ` Postal B 1 Telephone No. lax No. (9 0 5 ) 6 6 6 _ 1115171 9 9 10 5 ) 6 6 6=Code 0 2 9 1 Mailing address(ifdMlerent) b) Is your organization incorporated as a non-profit organization? []No ®Yes(It yes) Incorporation number CD 345806 'efsd c'o"O' Federal Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? ❑No ®Yes(It yes) ( Revenue Canada R number 10684 5100 11110001 I I I I I I I 1 I I I d) How long has your organization existed? What Is the financial year end of your organization Years 38 January 131 ay 3. Affiliates Is your organization affiliated with any corporation or organization? ®No Yes It yes: List the legal Nam(Attach separate sheet it necessary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Attadr separate shed It necessary,) Patient services at cystic fibrosis a) clinics b) Clinic grants C) d) Questions? call 1-800-387-0098 i oLc car 001(aeroe) Continued on bock 5. Lottery trust account;.: ',.: z _ � Name of financial Institution where lottery funds are held Account number I7— Address city- 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ❑No ❑Yes#f yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ® KENDRA UNORGANIZED D SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned,declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Wen � py-10 yo tid IB s It aid oneatn be Providing Inaccurate information may render your organization ineligible for advance funding Questions? Cali 1-800-387-0098 Ce formuloire est ousst disponibfe en fronGots. Canadian Cystic Fibrosis Foundation Fondation canadienne de la fibrose kystipe M7Mgr,IBUTION AL:file C Zr,,jm,) puty August 31, 1998 tant gr, Clk The Municipality of Clarington il. -- 40 Temperance Street z Bowmanville, ON L1C 3A6 Dear Sir/Madame: This letter is respectfully submitted along with an Advance Funding application form and supporting documents. Please let this letter serve as confirmation that the Durham Region Chapter is a bonafide Chapter of the Canadian Cystic Fibrosis Foundation(Business Number #10684 5100 RR0001; GIN#CCH0464), adhering strictly to its By-laws. Due to the fact that our Chapters cover large geographical areas, The Municipality of Clarington falls in the service area of Durham Region Chapter. In pursuit of our mandate to find,a cure or effective control for CF, the Canadian CF Foundation sponsors an extensive array of clinical and research programmes across Canada. Monies from gaming initiatives are dispersed in Ontario from bank accounts managed by the Foundation's Chapters to local cystic fibrosis clinics. Every spring and fall, rigorous competitions are held to determine which programs will be funded, and CF clinics undergo regular reviews by the Foundation. By funding only programmes with demonstrated merit, the Foundation can offer the best prospect for a cure or control for CF patients from across the country, including those from The Municipality of Clarington. The incredible advances in CF research over the past decade are proof that such an approach truly benefits all CF sufferers. Thank you for your assistance in these matters. If you have any questions please do not hesitate to contact Linda Salb at the Canadian Cystic Fibrosis Foundation's national office (1 800 378-2233). Sin erely, D rham Region Chapter President encl. Give the breath of life® Fight cystic fibrosis. Donnez le souffle de vie"' Combattez la fibrose kystique. Charitable Registration No./Numero d'enregistrement d'organisation charitable 0173872-11-13 APPLICATION #21 ostxfo tams to,ro,stla sxmtd Site80nno Please see attached page of Instructions. �o Foster Orin,Suite t300 P 9 Sault Ste.Marie,Ontario P6A6142 — Please print or type — 1. Previous charitable gaming licence • - • • Has your organization ever applied for a charitable gaming event licence? No ❑Yes(It yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing []No ❑Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name Canadian Diabetes Association, Durham Region Branch Street address of organization City Province 909 Simcoe St. N., #2 Oshawa ON Postal Code L I G 4W I Telephone No. 905 Fax No. ( )436-6648 � (905) 725-0216 Mailing address(il different) Postal Code b) Is your organization incorporated as a non-profit organization? F No �Yes(If yes) Jurisdiction of Incorporation number 11883 0744 RR0001 I Incorporation Government of Canada c) Is your organization registered as a Charitable Organization with Revenue Canada? Reg.number was converted to B 11883 0744 RR0001 No 0 Yes(If yes) Revenue Canada Reg.number I I I ( I I I I I I I d) How long has your organization existed? What is the financial year end of your organization Month Day Years L4 S y EvA(LS I August I 31 3. Aff iliates Is your organization affiliated with any corporation or organization? No ©Yes If yes. List the legal Names(Attach separate sheet if necessary) Our organization is a Branch of the Ontario Division of the Canadian Diabetes Association. a) b) 4. Use of net proceeds _7C) What will the advance funds be used for?(Attach separatesheet ifnecessary) _ Please see attached sheet. a) b) C) d) Questions? Call 1-800-387-0098 oLc CAP 001(99/05) Continued on back S. Lottery trust account Name of financial institution where lottery funds are held Account number Royal Bank of Canada 107-185-1 Address 1050 Simcoe St. I City Oshawa, ON 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No Yes(II yes,please indicate) ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED Q _000HRANE UNORGANIZED -------- -------RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer / Signature �. Susan Koster Print name in full Ted Savelle President Title Branch Coordinator ( i I (416)298-5141 I I I Business telephone number i I 1 (905)436-6648 i I 2 A2o Date Signing Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est ousst disponible en frongcis CANADIAN ASSOCIATION DIABETES CANADIENNE ASSOCIATION DU DIABETE October 28, 1998 Marie P.Knight. The Municipality of Clarington 40 Temperance St. Bowmanville,Ont. L1C 3A6 Re: Advance Funding Application Dear Marie P. Knight Please find attached our application to participate in the advance funding program. We have heard that the provincial government will be giving money to each Ontario municipality,to allocate to charities that provide services to local residents. Approximately 3600 people in Clarington have diabetes,a disease which can lead to complications such as heart attacks,blindness and kidney failure. The number afflicted will grow over time, as one in four baby boomers is expected to develop diabetes. In the hope that a cure is soon found for this disease, the Canadian Diabetes Association funds diabetes research. Until we find a cure,we will continue working to educate the public about diabetes and to provide services that improve the quality of life for people affected by diabetes in Clarington. We have enclosed an outline of the services we provide in Clarington. The costs mentioned in this outline are supported by the financial statements and budgets provided.Please note: as we have just recently begun our 1999 fiscal year,our fiscal 1999 operating budget has not yet been finalized. We have attached our most recent draft of this document. Please call us if you have any questions or require more information. We appreciate your consideration of our application. Thank you for your support in the fight against diabetes. Sincerely, i Susan Koster President, Canadian Diabetes Association,Durham Region Branch Durham Region Branch 909 Simcoe Street North#2 Oshawa, Ontario U G 4W1 Charitable Registration#1060754-11-13 (9(15) &m-66dR Few (9(15) 795-ng1h 7l 7-7 CANADIAN ASSOCIATION DIABETES CANADIENNE ASSOCIATION DU DIABETE December 1, 1998 To: The Municipality of Clarington Attn: Clerk's Department-Advance Funding From: The Canadian Diabetes Association Per your request, I have enclosed a cheque for the advance funding review and a list of our Executive Committee. Additionally, I have reworked some numbers concerning the funding request and have come to a figure that is far less than the original submission. I would ask therefore, that this new submission be reviewed rather than the previously submitted request. Thank you for your attention to this request. Sincerely, Ted Savelle Branch Coordinator cc: S. Koster,President Durham Region Branch 909 Simcoe Street North#2 Oshawa, Ontario L1G 4W1 Charitable Reglstratlon#1060754-11-13 (905) 436-6648 Fax(905) 725-0216 CANADIAN DIABETES ASSOCIATION,DURHAM REGION BRANCH OUTLINE OF CHARITABLE SERVICES PROVIDED TO The Municipalitiy of Clarington More than five percent of Canadians have diabetes, a disease which can lead to complications like heart attacks, blindness, nerve damage and kidney failure. There are approximately 3600 people with diabetes living in-Claringtorrright-now and-everyone--in-Clarington--i&4ikely-to-know-someone-with.the-disease.-_-- Our diabetes awareness and education services benefit everyone in the community.Education about diabetes prevention and about avoiding the complications of diabetes can change the quality of life for a great many people,and can result in substantial savings for our healthcare system.Research shows that most people with diabetes,even today,do not receive adequate self-care education.Until we find a cure for diabetes, our organization will be working to educate people in Clarington who are affected by it. All costs listed in the information that follows are supported by the figures on the organization's current operating budget,attached. The total annual cost for the Durham Region Branch of the Canadian Diabetes Association to provide its services to the public is $111,916. Our Branch is in a rebuilding phase that we began in earnest at our Annual Meeting in May 1998. Prior to this, for a period of two years,we were only able to provide maintenance service in our area. With our newly elected Executive we are now stepping into the community with specific goals and objectives that will provide better service and awareness about the effects of diabetes in Clarington. SERVICE DETAILS: 1. INFORMATION MEETINGS • The public are invited to attend our information sessions on diabetes, its prevention and its treatment. On November 24 our meeting will be held in Whitby with a local chiropractor and chiropodist giving information about their areas of expertise and its relation to diabetes. Two further sessions are to be held in the coming winter and spring. • We provide displays at public health forums, expositions and health fairs. This coming year will see us expand this activity to be proactive in seeking new locations as opposed to responding to requests. • We provide speakers to organizations and local companies to encourage a greater awareness of diabetes. Deliberate focus is being given to corporate and employee group presentations in the coming year. In the summer of 1998 we held two presentation sessions at Darlington Nuclear Plant for their maintenance workers as well as Pickering Nuclear Station. 2. REFERRAL SERVICES • In conjunction with Diabetes Education in our Region,we are developing an information brochure for distribution to medical facilities practitioners, and health care providers. At the same time, we are developing a general brochure for public distribution throughout Clarington. • People from Clarington regularly come to our office located in Oshawa to gather more information about our services and to pick up brochures and cook books available to the public. 3. SUPPORT GROUPS • We provide monthly diabetes information services at the Whitby Seniors Centre and in Port Perry for support groups participants. Our goal this year is to establish groups in Clarington. Ideally, we will be contacting our membership in Clarington and conducting a survey to determine needs in a support group system. We know from our experience in Port Perry and Whitby that this group interaction is _an.excellent vehicle-ta.keep_up.dated_on_diabetes._ 4. NEWSLETTER& DIABETES DIALOGUE • The members of the Canadian Diabetes Association in Clarington receive a quarterly newsletter from our local Branch -Diabetes Digest. The newsletter includes information about diabetes and diabetes management, details about the programs run by our Association and notification of upcoming local diabetes related events. • Four times per year, Association members also receive a copy of the national magazine; Diabetes Dialogue. 5. MEMBERSHIP SERVICES • Part of our ongoing services to our members will be yearly surveys to ensure that our activities meet the needs and requirements of our members. • On a yearly basis, we provide our membership with items that can be used as household tools- rulers, refrigerator magnets to name a few. These items contain specific information statements about CDA-address,phone etc. As a point of impact tool, it has been invaluable in reference back to the Branch. 6. BLOOD GLUCOSE MONITOR TRAINING: • With the continuing use of diabetes in our population, many individuals are not aware of the correct procedure to measure their blood sugar levels on a regular basis. To activate this service, we require the specialization of trained volunteers/staff who have the knowledge and ability to give accurate assessment of the reading and the appropriate action for the client to take. CANADIAN DIABETES ASSOCIATION,DURHAM REGION BRANCH ADVANCE FUNDING APPLICATION-ITEM#4,PROPOSED USE OF NET PROCEEDS Any funds allocated to our organization will be used to provide diabetes education, awareness and services to the community, as described in the attached outline. The services that would be funded include brochure publication for membership, general public and the medical profession, membership drive, support group development, education sessions at local hospitals, information evenings, special event development,expanded volunteer recruitment. We have received feedback from the community that suggests a great need for additional services that we do not yet have the resources to provide. With sufficient funds, we could carry out the following new projects: 1. INFORMATION MEETINGS • With an emphasis being placed on more information evenings, additional displays for education, and development of speakers,we anticipate that this will cost$300. 2. REFERRAL SERVICES: • A newly diagnosed individual has a variety of urgent needs that must be addressed. These include psychological concerns, a diabetes management regimen and control systems that are dealt with by the physician and a diabetes educator. Beyond these initial, sometimes fearful, reactions comes the new feeling of ownership and control of the disease. In this situation, people come to CDA for additional information about diet and diabetes management. At present we have a selection of specific diabetes cook books that can help an individual to better provide themselves with adequate nutrition and maintain the correct nutritional intake. • We propose that if we could provide the cook books free of charge to newly diagnosed members, we may be able to give them an early reactive measure to assuage their concerns. • We anticipate that,with our proactive membership drive for 99/2000, the costs for this service will be $720 in Clarington. 3. SUPPORT GROUP SESSIONS: • As we become an increasing source of reference and referral, the public has requested that we become more local in our approach in offering support. To this end, it is envisioned that we should and must provide opportunity for persons with diabetes to meet and exchange concerns, ideas and to share knowledge. In consideration of the manpower, technology and demands of this new service, we suggest that$200 is needed to initiate this activity. 4. NEWSLETTER AND DIABETES DIALOGUE: • At present our newsletter (two publications in the past 3 years) is dependent on budget constraints and sponsor cooperation. With the new and emerging information from the scientific community as well as our own local development, we believe that we must promote the newsletter service bi- monthly. This will require expanded funds to produce this product. We propose that $100 in advance.funding.will-cover.productionand_making-costs_for.this.information_service. 5. MEMBERSHIP SERVICES-LOW VISION DIABETES ASSISTANCE: • One of the complications of diabetes is blindness. In fact diabetes is the leading cause of adult blindness. As a result of this, many people with diabetes with low vision impairment require blood monitoring devices that have the capacity to give a verbal read out as opposed to a standard digital read out. We propose that the Canadian Diabetes Association is prepared to assume a portion of the cost if these monitors equal to the difference between a standard model and one that requires voice. Clearly there is a need for medical parameters required to implement this type of service. CDA will work with appropriate authorities to authenticate the diagnosis. We suggest that this type of service can be initiated with funding in the amount of$300. 6. SUMMER CAMP FOR CHILDREN WITH DIABETES: • Each year, our organization helps families in the community cover the cost of sending their children with diabetes to Camp Huronda. At camp, children can learn about managing their diabetes in a fun and safe environment. Parents benefit from the knowledge that health professionals are always on hand. Many children with diabetes first learn to assume responsibility for their own daily insulin injections while at Camp Huronda. • The cost to send a child to camp is $250. It is anticipated that as more and more children are diagnosed with diabetes,we will probably receive more requests for assistance. 7. BLOOD GLUCOSE MONITOR TRAINING: • With the continuing use of diabetes in our population, many individuals are not aware of the correct procedure to measure their blood sugar levels on a regular basis. To activate this service, we require the specialization of trained volunteers/staff who have the knowledge and ability to give accurate assessment of the reading and the appropriate action for the client to take. • To effectively promote and administer this service will require a minimum of$500. This will include training sessions for volunteers,recruitment advertising,transportation and material. TOTAL COST OF SERVICES REQUIRED BY THE CANADIAN DIABETES ASSOCIATION INFORMATION MEETINGS: $300 REFERRAL SERVICE $720 SUPPORT GROUP SESSIONS: $200 NEWSLETTER: $100 MEMBERSHIP SERVICES: $300 SUMMER CAMP: $250 GLUCOSE MONITORING: $500 TOTAL: $2.370 APPLICATION #22 Oibrk Loasry tornustloi 0FosteeOrim.Site8Xno Please see attached IOFosferOri�.Suile800 page of instructions. Saull Ste.Marie.Ontario P6A6V2 - Please print or type - 1. Previous charitable gaming licence FOR OFFIICE�USE ONLY: Has your organization ever applied for a charitable gaming event licence? ®No F�Yes(ll yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing ®No Yes privileges suspended in any juridication in the last two(2)years. 2. Information on organization GIN a) Incorporated or legal name CATHOLIC FAMILY SERVICES OF DURHAM Street address of organization City Province 670 King Street East Oshawa I Ontario Postal Code I Telephone No. Fax No. L 1 H 1 G 5 (9 0 5 � 7 2 5 _ 3 5 1 3 9 015 712 51 3 7 7 Mailing address(il different) Postal Code I b) Is your organization incorporated as a non-profit organization? O No ®Yes(ll yes) Jurisdiction of Incorporation number 545027 Incorporation Ontario c) Is your organization registered as a Charitable Organization with Revenue Canada? No ®Yes(it yes) I Revenue Canada Reg.number 110 0 6.1-81 810 I I 0 0 5 71 I P RR 0O P1 d) How long has your organization existed? May 30, 1983 What is the financial year end of your organization Month Day Years 15 12 31 3. Affiliates Is your organization affiliated with any corporation or organization? ❑No ®Yes It yes: List the legal Names(Altach separate sheet it necessary) Please see attached a) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet it necessary) Requested amount $210,000.00 a)P en ing P ograms & Parent Support b) Sexual Abuse Recovery Group Program for Teen Girls (13-16 yrs) c)Family Counselling _ d) Crisis Counselling for Abused Women Questions? Call 1-800-387-0098 orc CAP Doi(98/05) Conttnveo on Dock 5. Lottery trust account Name of financial institution where lottery funds are held Account number Bank of Montreal 8077-421 Address East Mall Shopping Centre City 600 King Street East Oshawa L1H 1135 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No F-1 Yes(If yes,please indicate) ALGOMA UNORGANIZED F� PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED [� RAINY RIVER UNORGANIZED KENDRA UNORGANIZED F-1 SUDBURY UNORGANIZED MANITOULIN UNORGANIZED [-� THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED F-1 TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitaole purposes only. • # �ee+l a f3fe�21RF" tihe:lee te= Not required as per enquiry to Ontario Lo Corporatio • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer >,; _ r SC�namre = toi Print nerve n Patricia Grant x ..-. SwF J. Drew Brown Executive Directors, Chairperson, Board of Directors Business telephone number. 9101 5) 7121 5I - 13151113 4111 6) 816 1 61 — 15 1 71 214 Oa"te.Styninp�,: October 23, 1999 "�""x' � October 23 1998 Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuioire esr ousst alspon0le en fron(�aas i 0 Catholic Family Services Of Durham MAIN OFFICE: 670 KING STREET EAST, OSHAWA, ONTARIO INN 5 Z-27 PH H 8 905-725-3513 50 COMMERCIAL AVENUE, SUITE 205, AJAX, ONTARIO L1S 21-15 905-686-4350 rrl/ FAX: (905) 725.8377 1998 of The Municipality of Clarington 40 Temperance St. Bowmanville, Ont. L1 C 3A6 Dear Sir or Madam: Enclosed is an application for advance lottery funding in the amount of $20,000 to assist Catholic Family Services of Durham to provide services to residents of Clarington in 1999. Our agency provides individual, couple and family counselling, family life education programs and specialized counselling programs for victims of violence i.e. primarily abused women and children. Last year 23% of our total clientele were residents of Claringtron (736 individuals). Our Oshawa office is located at 670 King Street East, close to Harmony Road; residents of Clarington do find our service accessible. Our services are available to anyone who resides in the region regardless of their religious background or their ability to pay. I have enclosed brochures as well as our audit for 1997. Please be advised that our reserve fund for building and equipment is for a projected move to an expanded office location in Oshawa. The monies are fundraising dollars raised to assist with leasehold improvements and equipment. We are presently searching out a suitable and affordable location. We plan to continue to be accessible to Clarington residents. Please contact me at 725-3513 if you have an questions about our application. Yours truly, Patricia Grant, I.B.V.M., M.S.W., C.S.W. Executive Director A Member Agency of Catholic Charities . A Member Agency of Family Service Ontario • A United Way Member Agency APPLICATION #23 Q+hrlo 4opiry Cayontlo� - so<rn�a,tor.drs a�roabdo 70 FosterDrl,e,Suite 6CO Please see attached page of Instructions. Sault Ste,hfade,ontado P6A6V2 — Please print or type — 1, Previous charitable gaming licence,- . Has your organization ever applied for a charitable gaming event licence? What is the most recent licence number issued by: AGCO: -P PAunicipality: M Have you had gaming event licences cancelled or licensing �No Yes privileges suspended in any Juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name Durham Re ion Community Care Association Street address of organization City Province 419 King Street West Suite 605 Oshawa Ontario Postal Code Telephone No, Fax No, L 1 1 J2 1 K 15 ( 9 t 0 1 5 ) 4 1 04 1 - 1 22 1 24 ( 9 1 054 0 4 _ 2 12 4 11 Mailing address(il different) Postal Code 1 f b) Is your organization incorporated as a non-profit organization? No Yes (Ityes) Jurisdiction of Incorporation number 520432 I Incorporation Ontario C) Is your organization registered as a Charitable Organization with Revenue Canada? No XX Yes(Ityes) I Revenue Canada Reg.number Ill 1 8 1 8 1 81 9L91 51 5 R i R10001 d) How long has your organization existed? What is the financial year end of your organization Years 21 years .Month Day I March I 31 3. Affiliates Is your'organization affiliated with any corporation-or organization? ©No Yes It yes: List the legal Names(Attach separate sheet it necessary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet it necessary) (See attached) a) b) C)- d) Questlons? Call 1-800-387-0098 OLC CAP 00 1(98105) Continued on bock 5. Lottery trust account Name of financial Institution where lottery funds are held Account number Toronto Dominion Bank To be arranged Address City 4 King Street West & Simcoe Street Oshawa 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ®No ❑Yes(if yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • 1 1we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer d { y't y ` tefg [ aka $y '� '�: .1,:.e E t n a fur „ �; ,; 7 L r 4 r. x x Elizabeth FulfordFrintnameinfutiri , ���`� � �'� §�,��� xi�� --Eleanor Ireland FxprIit iVp nirprtor Director, Finance & Administration -Bus ines F s-telep`ho�n,s number. ( 910 15 ) 4101 41 — 1 2121 21 4 r:, �� twx� (9 10 15 )4 101 41 _ 12 12 l4 +' E � . November 24, 1998 i, yd?ies�tgnny s November 24, 1998 Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formulaire esf oussi disponible en frongais. DURHAM REGION COMMUNITY CARE ASSOCIATION ADVANCED FUNDING REQUEST Communications - Internet $1,000.00 Year 2000 Compliance 5,000.00 Additional Computer Stations (2) 8,000.00 TOTAL REQUEST FOR ADVANCED FUNDING $14,000.00 APPLICATION #24 OsWk Left"Capon6oe SodgN get loferles de/ToWs 70 fosterOna',Suite 6W Please see attached page of instructions. Sault Ste.Mane,Ontario vuae►rz - Please print or type - 1. Previous charitable gaming licence . - . • Has your organization ever applied for a charitable gaming event licence? No r Yes(Ryes) - -- - - - What is the most recent licence number issued by: AGCO: P Municipality: M 428321 Have you had gaming event licences cancelled or licensing ®No Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name Grandview Children' s' Foundation G R C 0 2 1 9 Street address of organization City Province 600 Townline Road South Oshawa Ontario Postal Code Telephone No. Fax No. L i 11 H L7 IK 16 (9 10 15 7 12 18 _ 1 11 61 71 3 ( 91 01 5 ) 71 '21 81 _ 12 1 91 61 1 Mailing address(ildillerent) Postal.Coder b) Is your organization incorporated as a non-profit organization? F�No QX Yes(Ryes) Jurisdiction of Incorporation number 1139492 Incorporation Ontario, Canada c) Is your organization registered as a Charitable Organization with Revenue Canada? No ©Yes(llyes) Revenue Canada Reg.number 8 9 1 0 5 8 5 4 7 R R 0 0 0 I I I I I I 1 1 1 1 1 d) How long has your organization existed? What is the financial year end of your organization Month Day Years 3 years March*1 31 3. .Affiliates — �-- •..-.___._.....__.._. Is your organization affiliated with any corporation or organization? ®No F-]Yes It yes: List the legal Names(Attach separate sheet it necessary) a) b) 4. Use of net proceeds What will the advance funds be used for? (Attach separate sheet it necessary) Pr m 00 N i �! e--,l � I L)� SEE ATTACHMENT a) b) C) d) Oueslions? Call 1-800-387-0098 oLc CAP 001(sa/os) Continued on bock 5. Lottery trust account _ institution whereto r , ��.e be '-c- Name of financial tte w beld �••-,•,:.h�;, '� :•:-,::: ---- .� • ryfunds area unt number '4 ar .•.-'..' :..�. r.. .l% .�P:u.+4iA4i.•.Ae✓T:w+{!►�'MM'JN +5� %•'i...t....+:.:... _r-.- ... .. Royal Bank of Canada 100-001-7 ' •� Address 1405 King Street East City Courtice, Ontario i. Unorganized Areas Is your Charitable organization located in-an unorganized area? X❑No ❑Yes(ll yes,please indicate) . ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED CDCHR7CNEl1NOR�A IZED ❑ RAINY RIVER UNORGANIZED ❑ KENORA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. PrinWotri/ier Pf alOicer Signature= '' ' %i arold ` Print In name �:�: , Charles J . Ryan Chair, Board of Directors;;= **�ti ;rTjtle: ::f,.r y Vice Chair, Board of Directors Business ri 3 1 0 1 5 � 5 1 7 1 1 1 _ 1 0 15 11 5 telephon e nutnber r 9 0 5 1 6 4 4 1 7 4 4 6 + Date Signing;, + Providing inaccurate information may render your organization ineligible for advance funding estions? Call 1-800-387-0098 Ce formuloire est oussi disponible en trongois. Attachment 4. Use of Net Proceeds Proceeds would be used by Grandview Children's Centre to provide services to children in Durham Region with physical disabilities and communication disorders. In the year ending March-31, 1998 2,614 children from Durham Region were treated at Grandview. The main facility is located in Oshawa where-a—resa"lite-offices------------------------ in Port Perry to provide services to the children and their families in North Durham. The other office is in Ajax and treats children living in West Durham. Over the past year, Grandview's physiotherapists, occupational therapists and speech pathologists provided treatment for approximately 450 children and their families residing in the Municipality of Clarington. November 6, 1998 Marie P. Knight GRANDVIEW Deputy Clerk CHILDREN'S Corporation of the Municipality of Clarington CENTRE 40 Temperance Street 600 Road South Oshawawa,,O nto gowmanville, Ontario L1 C 3A6 Ontario LIH 7K6 !� ----------ret0hout-9or-72S 7M____ _ _ ___ _ Fax 905-728-2961 Dear Ms. Knight, Re: Application for Advanced Funding We are pleased to provide the additional information you requested regarding our application for advanced funding. 1. We are requesting $35,000. The funds would be used to supplement the annual operating budget of the Centre which has had its funding frozen since 1993. We find it is necessary to use this money for operations, as the high growth in Durham Region of young families combined with an extremely lengthy funding freeze has put tremendous strain on the Centre's ability to provide health care services to the Region's special needs children. 2. Grandview Children's Centre has benefited the Municipality of Clarington since 1954 by providing a range of health care services and supports to children and young adults with physical and communication disabilities living in Durham Region. Last year, over 450 children and their families living in the Municipality of Clarington received services at Grandview. These services included: audiology; speech language pathology; occupational therapy; social work; and physiotherapy. Specialized services include a Seating Clinic, Orthopaedic Clinic, Orthotics Clinic and a unique community-based Preschool Outreach Program. The programs offered at Grandview are designed to support the child and family in achieving an optimum level of independence in Their home and their community. If you should require any additional information, please do not hesitate to contact` me. Yours truly, Linda Watson - Executive Director Grandview Rehabilitation&Treatment Centre of Durham Region A Registered Charitable Organization • APPLICATION #25 Sftw 70FWWarntsr,*&V Please see attached page of Instructions. PM 6W - Please print or typo 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? ©No ❑Yes(11 yes) What is the most recent licence number Issued by; Munidpalfty: Have you had gaming event licences cancelled or licensing privileges suspended in any)uddication Ih the last two(2)years? ©No []yes 2. information on organization GIN a) Incorporated or legal name Kawartha Child Care Services Street address of organization CMy 201 Antrim Street (Head Office) Peterborough ON PWW Code Tebphone No. fan No: a Malling address(90tt►4 Code b) is your organization lncorpon tad as a non-piofM orpaftbft? No Juriadlctior�ot ®Yet$(Myes) Incorporation number 498551 Incorporation Ontario 0 Is your organOtion registered as a Chaftble Organzation with Revenue Canada? ❑No QX Ye:(ayes) • Revenue Canada Pao.number 0 1 7 1 7 1 5 1 8 12 1 5 1 - 10 111 d) Now long has your organization existed? Whitt Is the financial year and of your orpartWon Years 17 I Mart I 3 Day & 11fNlfalltas Is your organization attilided with any corporation or orpeniadon? rn°O� ®No . . Oyes ON. L1$f feeW9Abmes(Afbdr Me$beef 1l nerxsaery) a) b) 4. Use of net proceeds What WIN the advance funds be used for?(Aftachsegoaraibam11necmmy) a) Toys & Equipment b) Professional Development c)_Program Maintenance d RPM irs ) Offostiosst Cali t-800-387-0098 ac CAP 00 l(96M Cont 1 ad 06 b o S. Lottery trust account Name of financial Institution where lottery funds are held Account number Toronto-Dominion Bank f i 4 Address George Street Peterborough 6. UnofgWdnd Am" Is your Clta tlB orpanflon located In an unorpanind area? ❑X No' ❑Yes(li yep Please indirafe) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED ❑ CO_CH_RANE_UNORGANIZED —__.-❑.-RAINY RIVER-UNORGANIZED _ ___ __ _ ____ ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned,declare that: • Ifwe are a Principal Officer of this organization, • I fwe are NOT receiving remuneration directly or Indirectly from the advance funding. • Ifwe have been authorized to make this application on behalf of the organization, • Itwe agree to deposit all advance funding into the designated lottery trust account. ` • I/we agree to use the advance funding for approved charitable purposes only, • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and undsretand the entire Declaration above. PrinciwI Offker J:. }V.,rq 6 Princbai OMber J et M. Castle ti!`� a Dettenkof -Le ...,{ Ad ah Executive Director ""i..,.' President � 7I01 5 714191 — I314I0 -0 " �,: � .,A:. . �;:::'• (7 10 1 5 6 15 12 1 _ 10 3 x.0.15 •ire Ci Providing Inaccurate information may rondo'your organization ineligible for advance fundhv Oaesfions? Cali 1-800-387-0098 Ce forrnulaire est aussi disponible en frongais• oytild Car 'a shy 201 Antrim Street Peterborough, Ontario K9H 3G5 �C y Phone (705) 749348 Fax(705) 749-9788 02 November 1998 __Municipality-of.Clarington_ _ ___ Clerk's Department 40 Temperance Bowmanville, ON L1 C 3A6 Please find enclosed our application for funds through the Ontario Lottery Corporation Advance Funding Initiative. This application is intended to support our Child Care Centre operating in Courtice. We have been operating this centre for 7 years. We request$5,000.00 to update our toys and equipment and build a shade structure for our playground. Our attachments have been numbered as follows; • Application #1 • Governing Documents #2 • Revenue Cananda Notification #3 • Detailed outline of Programs #4 • Operating budgets current/last period #5 • Financial Statements #6 • List of Board of Directors #7 If you have any questions about our organization please call. Sincerely, 1 anet M. Castle Executive Director Today's Children, Tomorrow's Future APPLICATION 126 0abdo Lofty C07mifafi sodili dog 10(ofes if 1,00we 70 Fostet Drive,Suite 80 Please see attached page of Instructions. Sault Ste.Made,Ontario P6A 6V2 - Please print or type - DURHAM 1. Previous charitable gaming licence FOR OFFICE USE ONLY- H s your organization ever applied for a charitable gaming event licence? ----------------------------------------go-----------M_Yes_(1TyesV ——-—-------------------------—--——--------------------------------------------------------------------- What Is the most recent licence number Issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing DNo MYes privileges suspended in any jurldication In the last two(2)years? 2. Information on organization GIN. a) Incorporated or legal name Kinark Child and Family Services Street address of organization city Province 240 Duncan Mill Road Suite 402 Don- Mills ON Postal Code Telephone No. Fax No. MI 31 B 1 31 B 1 2 4 1 11 6 ).3 1 91 1 1 1 3 1 81 8 1 4 4 1 1 1 6) 4 4 4 1 18 18 1 9, 6 Mailing address(Ifoliffetent) Postal Code b) Is your organization incorporated as a non-profit organization? M No Yes(If yes) 264585 ( Jurisdiction of Province of Ontario Incorporation number Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? MNo [;j Yes(If Yes) I Revenue Canada Reg.number 11.819 18 1 1 1 .1 1 21 51 R I RI. 0 1 0 101 d) How long has your organization existed? What Is the financial year end of your organization Month Day Years Twenty-Five March I 31 3. Affiliates Is your organization affiliated with any corporation or organization? ENo Yes llyes: List the legal Names(Attach separate sheet if necessary) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet if necessary) a) PLEASE SEE ATTACHED FORM b) C) d) Questions? Call 1-800-387-0098 OLC CAP.001(98105) Continued on back 5. Lottery trust account _ Name of financial institution where lottery funds are held Account number THE TORONTO DOMINION BANK 0403 0602335 Address City King Park Plaza, 245 King Street West OSHAWA 6. Unorganized Areas Is your Charitable organization located in an unorganized area? ❑ X No ❑Yes(l/yes,please indicate) -----------_ _ _-O--ALGOMA-UNORGANIZED ------ ------ -- - ❑-PARRY SOUND-UNORGANIZED ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We,the undersigned,declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • i/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • I/we will sponsor table game events at the local charity casino. ^ • All answers provided in this Application, as well as all the Information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Princi al Officer Princl elONicer r •� ; �``�Signatura F= x� . A 1-Iii YS Myt '' 7 a�'i`.j'AZtz Neville Jones x,�Ptintnameintuiiz ° s Director, Finance Director, Human Resources urines telephon nambern / 41116 3191 11 - 1318181 4 M�� e a ` _l 4 1 11 6) 31 9 1 11 — 111 81 8 1 4 October 26, 1998 ft�� Oat11. � rfpZ October 26, 1998 Providing inaccurate Information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formulcire est oussi disponible en frongois. KINARK Child Child and Family Services and 240 Duncan Mill Road Family suite 402 Services Don Mills,Ontario M3B 3B2 Telephone(416)391-3884 ADVANCE FUNDING APPLICATION M-- f3N- 4--=_U51`_OF-NEfi"'__PR0Ci=ED5 ___ - ----- -------- _.__ --------- DURHAM REGION Kinark Child and Family Services is one of the largest non-profit children's mental health centres in Ontario, operating across six areas of the province. Our mission is to strengthen the social, emotional and behavioural well-being of children and their families. Last year in the Durham region we served more than 750 families. We offer a wide range of counselling, classroom, residential and psychological services as well as having a strong volunteer program. Durham Region is one of the fastest growing areas in Canada with many new immigrants settling daily in the region. Kinark has recognized the value in reaching out to those families. To this end we have initiated a diversity program that is designed to network within our community to encourage families from diverse cultures to utilize children's mental health services as needed. In the spring of 1999 we are planning a weekend program for families who are dealing with issues of racial or cultural discord. Specifically we will be targeting high risk parents and children who are socio-economically challenged. The Parenting in Canada project will take place at the Kinark Outdoor Centre,just outside Minden with approximately 16 families attending. The weekend program will include workshops and panel discussions for parents and children. Several speakers will address issues around teenage pregnancy, street crime, street drugs,spiritualism and the Canadian educational system. This weekend will be provided at no-cost to the families. Kinark's cost to provide this event will be $11,119. The budget is broken down as follows: Camp Costs ($368 per family X 16 families) $ 5,888 Transportation $ 731 Speaker Honoraria $ 2,500 Pre-Weekend Support/Materials/Supplies $ 2,000 TOTAL COST $11,119 Income Tax Donation Ranigtratinn anAmAgi_i i-is KINAAK Child and Family Services Child and 240 Duncan Mill Road Family suite 402 Services Don Mills,Ontario M313 362 Telephone(416)391-3884 November 25, 1998 Marie P. Knight Deputy Cleric The Municipality of Clarington 40 Temperance Street Bowmanville, ON L1C 3A6 Dear Ms. Knight: As requested in your letter of November 6, 1998, I have attached a$25.00 processing fee to accompany our application for advanced funding. As well, I have attached a short explanation on how Kinark benefits residents of Clarington. As well, in your letter you were looking for confirmation of the amount that we were requesting. The total amount of our project is $11,119, however, we would be thrilled to receive any amount of money towards this cause. Please do not hesitate to call me if you require further clarification. My phone number at Kinark is 416-391-3884 x310. Regards, / Sara Lanthier Executive Assistant Income Tax Donation Registration#0409821-11-13 Established in 1984, Kinark Child and Family Services is a one of the largest non-profit Children's Mental Health Centres in Ontario. Kinark operates in five regions across the province including the Durham region. Kinark is a fully accredited member of the Ontario Association of Children's Mental Health Centres. Our mission is: T-o--strengthen the-social,--emotional-and--behavioural i4)ell=being of children and their families. We seek to achieve this goal by being a provider of choice in the delivery of the highest quality services to our clients in partnership with community resources. Kinark is governed by a volunteer Board of Directors with representation from each of the program areas in which we operate. The members of the Board come from a variety of professions and occupations bringing a range of skills to Kinark. The board encourages representation from former clients and parents to ensure the agency has access to and/or knowledge of the consumer's perspective. Additionally, in each of its program areas, a Parent or Consumer Advisory Committee is in place which meets regularly to discuss issues, identify service needs and gaps and make recommendations to management teams on how Kinark might better serve the local community Kinark provides a broad range of services to families in Durham Region. The Durham Program offers services for children up to the age of 12 and their families. The exception to the age requirement is our Families First program that provides services for children up to the age of 18. We have available a multi-disciplinary team that includes social workers, child and youth workers, psychology staff, psychiatric consultants and nursing staff to assist in providing the most effective services possible. We also aim to deliver services in ways that are sensitive and show respect for each family's cultural, racial, religious and language diversity. Since April 1, 1997 the Kinark Durham Program has served 75 clients from the municipality of Clarington. APPLICATION #27 MM Motto Leftry CofVmb0I sadlli/110001 is rostulO 70 Foster Orim.Suite Boo Please see attached page of instructions, Saull Ste.Marie.Ontario P6A6V2 - Please print or type - 1. Previous charitable gaming licence Has your organizatio ever applied for a charitable gaming event licence? - _Q No -------_ Yes.(Il yes) _ — _... t} _ _1- - _-1�-�-t�--fit t�u�-rya }���� What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing privileges suspended in any juridication in the last two(2)years? ° ❑Yes 2. Information on organization GIN a) Incorporated or legal name Y rA c, a 'lam l iZk �1IrY�%S b �J Street address of ganization City P vince _ LLAakli 4,': Postal Code Telephone No, i Fax No. MIDI �h IVI I I FI Mailing address(i1 different) Postal Code b) Is your organization incorporated as a non-profit organization? No Yes(if yes) �� Jurisdiction of Incorporation number '� 1 `T Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? No ' Yes(It yes) I �1 C i Revenue Canada Reg number d) How long has your organization existed? What is the financial year end of your organization Years I Month Day 3. Affiliates Is your organization affiliated with any corporation or organization? No Yes it yes: List the legal Names(Attach separate sheet if necessary) aW l(6_4e_rJ uC'�tk-� LD S4r Se, wad _b ry s CAS vry- a)bic"fic�:�� I ('s;�t�� I �S �m,� iS C_-)' 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet if necessary) C) d) Questions? Call 1-800-387-0098 oLC W 001 c9ar05> Confrnueo on bock 5. Lottery trust account Name of financial institution where lottery funds are held Account number Address I city 6. Unorganized Areas Is yo)K Charitable organization located in an unorganized area? No ❑Yes(It yes,please indicate) �❑_-ALG©MA-UNflRG-ANfZED—__ - _ __-------------------------- ---___--- ❑ P7CRRY-SOUN�RGANIZED --- ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • Itwe agree to use the advance funding for approved charitable purposes only, • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Princi at Officer Principal Officer ' Signature z M:4 DIRECTOR OF REGIONAL OPERATIONS Titles Di e1�� PO - T Y ✓ /G Business telep[ione�numher I I Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formulo,re esr cuss,d,sporr,ole en tronGo,s. Honorary Patron/Pr6sidente d'honneurONTARIO LA MARCHE V The Honourable Hilary M,Weston, MARCH DES DIX SOUS Lieutenant Governor of Ontario September 23, 1998 OF DIMES DE UONTARIO L'honorable Hilary M,Weston, Independence for Adults with Physical Disabilities lieutenonte-gouverneure de I'Ontario Autonomie pour adultes ayant un handicap physique Municipality of Clarington Patrons/Comit6 de patronage Lottery Licencing Department The Honourable Lincoln M.Alexander 40 Temperance Street Bowmanville, Ontario L'honorable Lincoln M.Alexander WC 3A6 The Honourable Henry N.R.Jackman Attention: Charity Roster Applications L'honorable Henry N.R.Jackman Advance Fundinef Oscar Peterson C.C. Please find enclosed our Advanced Funding Application Veronica TennantO.C, to the Municipality of Clarington. This funding would allow Ontario March of Dimes to assist adults with Honorary Chair/Pr6sidenthonoraire physical disabilities in the Municipality of Clarington through a variety of programs we offer in this The Honourable David R,Peterson, community. P.0"°'C In the Municipality of Clarington, Ontario March of L'honorable David R.Peterson, Dimes spends thousands of dollars every year purchasing C.P.,ca, mobility equipment for adults with physical disabilities. In addition, our organization provides Post-Polio Support and Camping and Recreation Programs President/President to residents of the Municipality of Clarington. Duncan P.Read Ontario March of Dimes believes that the best way for adults with physical disabilities to achieve independent and fulfilling lives is to enable them to Executive Director/Directriceg6n6rale choose for themselves the tools they need to enhance AndrioSpindel their independence of movement, job skills, lifestyle and housing. Our organization works with adults with disabilities in obtaining devices that facilitate basic Charitable Registration No, mobility and communication, and provides a range of Noenreg.oeuvre debienf. Services designed to help people increase their income opportunities and shape their future with our (BN) 107883928RR0001 Employment Services Program. Ontario March of Dimes operates a variety of recreation programs for adults with disabilities, through our Camping and Recreation Central Region Program and our Post Polio Support Groups, and through P.O.Box 2220,City Hall Complex an established registry, provide the latest information on Post-Polio Syndrome to post-polio survivors. In Oshawa,Ontario addition, through our Independent Living Assistance L1H7V5 Program, Ontario March of Dimes- attendants provide non- medical assistance to adults living in their own homes and in certain non-profit housing projects . Region du Central C.P.2220,Complexedel'hoteldeville Our organization is requesting $6, 000 from your municipality to assist us with a number of projects we Oshawa(Ontario) seek funding for. Dollars from the Advance Funding L1H7V5 program will be used to purchase mobility equipment (ie. walkers and wheelchairs) for adults with physical disabilities living in the Clarington community, Tel./T616p.: (905)434.5280 Fax/T616c.: (905)436-2862 Web site/Site Web: www.omod.org 2 specifically those residents currently on our waiting list. In addition, our local post-polio group is looking for funding to attend post-polio conferences and to fund their monthly newsletter. We have individuals on our waiting list for ADP who reside in Bowmanville, and Courtice. ----------- --------------------------- ------- ---------------1_________________'___' ----------------- ------ If you require further information about our organization and/or our services, I would be pleased to speak with you at your convenience. Thank you for your consideration and we look forward to hearing from you. Sincerely Denise Harding Fundraising and Volunteer Co-ordinator Central Region C.C. Sybille Hahn, Regional Director 11/17/98 10:20 V905 773 5176 OMOD OAK RIDGES 0 002 The Honourable Hilary M,Weston, ONTARIO LA MARCHE Lieutenant Governor of Ontario MARCH DES DIX SOUS L'honcrable Hilary M.Weston, \;Md OF DIMES DE VONTARIO lieutenante•gouverneure de('Ontario Independence for Adults with Physical Disabilities Autonomie pour adultes ayant un handicap physique Potrons/ComiM de patronage November 16, 1998 The Honourable Lincoln M.Alexander L'honoroble Lincoln M.Alexander Ms. Marie Knight The Honourable Henry N.R.Jackman Clerks Department Pfionorab7e llenry N R Jockmnri-------- --------Municipality-of Clarington- -------------------------_.--- --------- Oscar Peterson C.C. 40 Temperance Street Bowmanville, Ontario Veronica Tennant O.C. L 1 C,' 3A6 Honorary Chair/President honoraire Dear Ms. Knight; The Honourable David R.Peterson, Pursuant to our conversations today,I am sending you further information P.C.,°'C regarding Ontario March of Dimes and the work we have done in the Chonorable David R.Peterson, Municipality of Clarington in the last two years. C.P.,c.r. As mentioned in my previous letter, Ontario March of Dimes has provided President/President services to residents in the Municipality of Clarington through our Post Polio Support Group ($3,992 to support Post-Polio survivors in the Municipality of Duncan P.Read Clarington)which provides information to polio survivors,raises awareness of post-polio syndrome among members of the medical profession, supports the Executive Director/Direetrice ginerale development of local support groups and encourages research. In addition, our Andrio Spindel Assistive Devices Program (in 1997/98) spent$2,465 on mobility equipment for consumers in the Municipality of Clarington including the purchase of mechanical lifts, scooters and wheelchairs. Charitable Registration No. No enreg,cavvre de bienf. Our organization is requesting$7,000 from the Advance Funding Program (8N)10788 3928 RR0001 which will allow us to serve consumers in the Municipality of Clarington who are currently on our Assistive Devices Program waiting list and to purchase computers and software for our Durham Office which would assist us with the Central Region cost of making all of our computer hardware and software "Year 2000 13311 Yonge St.,Suite 202 compliant". Richmond Hill,Ontario Richmond Our$25.00 application fee is being sent to you under separate cover. UE If you require any further information,please contact me at(905) 773-7758 ext. R69ion du Central 212, 13311,rue Yonge,bureau 202 Richmond Hill(Ontoriol ncerely, WE 3L6 �T e se Harding Tel./Telep.: (905)773.7758 Fundraising and Volunteer C - dinator 1-800.567.0315 Central Region Fax/T616c.: (905(773.5176 Web cite/Site Web: www.omod.org APPLICATION #28 M=Rmm IRS= o.trw twrr cn..«. swwt wr ar.n.w rt>awy. 70 Foster Drive.SuiteBW Please see attached page of instructions. Sault Ste.Mane.Ontario P6A6W - Please print or type - 1. Previous charitable gaming licence FOR • ONLY- Has your organization ever applied for a charitable gaming event licence? [_X No 0 Yes(it yes) What is the most recent licence number issued by: AGCO: P Municipality: M Have you had gaming event licences cancelled or licensing NO Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name Saint Elizabeth Health Care Street address of organization City Province 209 Dundas Street East, Suite 303 Whitby Ontario Postal Code Telephone No. Fax No. L 1 N 7H8 ( d o n� q I I I I I ( \ 190th ) I �130FUg7 I I 1 19015 ) 1 4J10-12921 1 1 1 Mailing address(d dilietent) I I Postal Code I I I I I b) Is your organization incorporated as a non-profit organization? f7 No ®Yes(ll yes) 014070 Incorporation n Ontario Incorporation number ' Incorporation c) Is your organization registered as a Charitable Organization with Revenue Canada? No [aYes(It yes) I Revenue Canada Reg.number 111913 20901 RR0001 I I I I I d) How long has your organization existed? What is the financial year end of your organization Years 90 years Month Day( 03 31 3. Affiliates Is your organization affiliated with any corporation or organization? �X No ❑Yes It yes: List the legal Names(Attach separate sheet it necessary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separate sheet it necessary) a) program development & enhancements b) medical equipment & technical advanceme c) continuing education & technical training d) charitable visits/compassionate visits Questions? Call 1-800-387-0098 OLC CAP 001(98105) Continued on Dack S. Lottery trust account I ' Name of financial institution where lottery funds are held Account number We do not have a lottery trust account at present because we have never held a licensed Address City 6. Unorganized Areas Is your Charitable organization located in an unorganized area? PNo Yes Ill yes,prease rnarcatet - --- - ALGOMA UNORGANIZED PARRY SOUND UNORGANIZED COCHRANE UNORGANIZED RAINY RIVER UNORGANIZED KENDRA UNORGANIZED SUDBURY UNORGANIZED F7 MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED NIPISSING UNORGANIZED TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only, • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Pdncioal Officer Principal Officer Signature Sh i r l ee Sharkey Phut name in full President & C.E.O. Tttie ( 1995 � 1 140 9655, //224 eeriness telephone number 0C�1 30 / �' o>ite Signing �. . . Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formularre esf aussr disporubfe en fronpars. S a i n izA e t h October 27, 1998 Municipality of Clarington City Clerk's Department 40 Temperance Street owmanvi e A --------- ---- -- ____ -------- -------- ---_ _- Dear Sir/Madam: On behalf of Saint Elizabeth Health Care, please find enclosed an application for the Advance Funding Program. The funds we are requesting will benefit the Municipality of Clarington, where we provide vital community health care services out of our Durham Region Office in Whitby. Please note, this application was completed at our Head Office in Markham because it is the site of our Provincial Fundraising Office. Please understand that funds provided as a result of this program will be designated to the charitable needs of the Clarington community. Saint Elizabeth Health Care is a voluntary, not-for-profit health care organization that has become a leader in the provision of community health care services in Ontario. Since its inception in 1908, Saint Elizabeth's has grown from a few dedicated nurses to a staff of over 1,900 health care professionals. Our services have also grown with the ever-changing, dynamic health care environment to include very sophisticated and technical procedures such as intravenous infusion, chemotherapy, dialysis and oxygen treatment, as well as several very specialized disciplines. Saint Elizabeth's provides over 1.5 million visits a year to clients and their families in the regions of Greater Toronto, Durham, Peel, York, Ottawa-Carleton, Kitchener-Waterloo, Niagara, London & Middlesex, Windsor & Essex and Simcoe County. 'We have served the Durham Region for almost ten years and were providing over 15,000 visits monthly to clients within that area before our much publicized strike. Specifically, in the Municipality of Clarington, we were providing approximately 2,000 visits monthly to clients. With the recent settlement of the strike we expect to be operating at the same levels in the near future. Your support will benefit the Municipality of Clarington by enabling us to: • enhance and expand the programs and services we provide to your community; • purchase technologically advanced medical and teaching equipment to ensure the provision of leading-edge community health care; • provide our health care professionals with the continuing education and advanced technical training necessary in the delivery of leading-edge community health care, and; • provide free (compassionate) visits and/or extended visits to clients that do not have health care coverage or whose needs have extended beyond what is covered by their health care coverage. B R I N G I N G H E A L T H T O L I E E °TF; CCHSA 90 Allstate Parkway, Suite 300,Markham,Ontario DR 61-13 Tel:905 940.9655 Fax:905 940.9934 www.saintelizabeth.com CCASS ACRE:E A full Case Statement is enclosed describing the charitable needs of our communities and the programs and services we provide. I highly.recommend you review this document to gain a better understanding of the charitable needs and how your community will benefit from your support. --— _— _ - _ --------- -------- --- ------- _ - - --- - Also, enclosed you will find governing documents, notification of registration by Revenue Canada, operating budget, our Annual Report including financial statements and a board listing, and an organizational brochure. If you require any further information or have any questions, please do not hesitate to call me at 1-905-940-9655, ext. 2139. If this request receives a positive response, please forward the cheque to Head Office where it will be deposited and allocated internally. Thank you very much for your consideration. Sincerely, Kira Crozier Provincial Fundraising Manager /encls. B R I N G I N G H E A L T H TO ( I f E APPLICATION #29 TIM $"1014 d's 101.4"0,1,04M. 10 rostel Oriw.Sm"..800 Please see attached page of instruclions. SYJlt Ste.Ablie.Ontario P6.4 6V.? Please print or type 1. Previous charitable gaming licence FOR OFFICE USEONLYS Has your organization ever applied for a charitable gaming event licence? ------ ------ UNo [X]Yes(if yes) What is the most recent licence number issued by: AGM P 9 345,E Municipality: M Have you had gaming event licences cancelled or licensing ONo Yes privileges suspended in any juridication in the last two(2)years? 2. Information on organization (Qq�C)h ()-F JXLV�ja vI &aM) ) GIN a) Incorporated or legal name -Tie- Q� cros.:5- —.smi G R G 1191 Street address of organization j city Province VA St W eifG LIS :ULU Postal Code Telephone No. Fax NO. L-+ 1 11 1;6 Aoi6 ) 'h2i3i - i2iqi �3i3. ( q, 06 ) 714 31 - I qtQA20 Mailing address(ildiflefert) Postal Code b) Is your organization incorporated as a non-profit organization? rjNo Yes(1/yes) Jurisdiction of Incorporation comber Incorporation c) is you. oroani_lion registered as a Charitable Oroanization with Revenue Canada? N o Yes (ilyes) Revenue Canada Reg.number I c(I 2� r-11 000 d) Ho-w long his your organization existed? What is the financial vz--r end of your organization Month Day Years IOA st 3. Affiliates Is your organization affiliated with any corporation or organization? IwNo 0 Yes 11},es: List the legal Names(ktanh separate sheel it necessary) 2) b) 4. Use of net proceeds What will thie advance funds be used for?(Allachsgparale sheet ifnecessary) �c Cat 2) 1(9 b) C) P l L Scar uicy_5 d) 4 rw( 'e—S Questions? C�,I 1-800-387-0098 Coniinu&C on OOC- -AP 001 C, 5. Lottery trust account . Name of financial Institution where lottery funds are held Account number l C t ' g .G mil- 103 tS Address City '4-1�t Sic• \�A G. Unorganized Areas Is your Charitable organization located in an unorganized area? NrNo ❑Yes (1/yes,please indicate) ----- - ---ALGOMA_UNORGANIZEO - _ --❑ PARRY-SOUND-UNORGANIZED- -- - -- ❑ COCHRANE UNORGANIZED ❑ RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAYUNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from theadvance funding. • I/we have been authorized to make this application on behalf of Ile organization. • I/we agree to deposit all advance funding into the designated lolery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • All answers provided in this Application,as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer >7. .. Signature -Print name in ful' 1n CA r-vt t-- T �C�\C�C.N� : .. •. `Title - Business telephone Nmber; � Q�S -4 2131 — l ]Zq1 �I� l'ZI �I I � _JI I It Z03 <• Signin • Date - 9:a. . Providing inaccurate information may render your organization ineligible for advance funding t?ues; ns? Call 1-600-33-S.7-0098 Ce(o(mu!crr=03;cuss,d,s_-on,e,!e en (ranGois. 905-723-9023 CENTRAL LAKES REGION 228 P02 NOV 25 199 13:5e To: Marie P. Knight, Deputy Clerk, Corporation of the Municipality of Clarington, Fax 905-623-0830 ---- --------------- From:-Donna-D3 Vandertuin,-Branch Manageu---- Canadian Red Cross Society - Region of Durham Branch Fax 905-723-9023 Re, ADDITION TO LETTER SUBMITTED BE: ADVANCED FUNDING PROGRAM To further clarify, be advised that all training and programs submitted for your consideration under the Advanced Funding Program are to benefit the residents of the Municipality of Clarington only with the exception that project #3, the Clarington Recycling Program is open to all residents of Durham - however, we believe it best serves the people of Clarington because of its location and the fact that most of our volunteer workers reside in the Municipality of Clarington and statistics prove that most people taking advantage of this program come from the Clarington area. We believe these projects, totalling $25,842 will directly enhance the lives of the residents of the Municipality of Clarington and in many instances, enable them to deal with problems themselves. Your consideration to funding, in full ($25,842) or in part, by choosing the projects you feel would best enrich the lives of your residents, would be greatly appreciated. Please feel free to contact me at any time should other questions or concerns arias. Donna D, Vandertuin 905-723-7251 ext. 203 Canadian Red Cross or Friends for Life Croix-Rouge canadienne Ensemble pour la vie The Corporation of the Municipality of Clarington, 40 Temperance Street, BOWMANVILLE, Ontario. L1 C 3A6 Attention: Marie P. Knight, Deputy Clerk Dear Ms. Knight: We respectfully submit the following budget for consideration for funding through the "Advanced Funding Program". Attached is other documentation as required. 1 . EMERGENCY RESPONSE/PERSONAL PREPAREDNESS PROGRAM: Addressing the commitment to respond in an Emergency as written in the Region of Durham Emergency Plan, hold two emergency response team courses for interested individuals wishing to become trained in the Municipality of Clarington. Materials cost $10 per person x 15 x 2 .......................................$ 300.00 Volunteer co-ordination and training for workshops $19 hr. x 7 hrs. x 2................................................................... 266.00 Deliver ten Personal Preparedness workshops to interested members of the public through-out the year. A series of "What to do in case of" fire, flood, electrical storm, etc. Materials cost $10 per person x 25 x 10....................................... 2,500.00 Volunteer co-ordination and training for workshops $19 hr. x 5 hrs. x 10................................................................. 950.00 �7i�19'��• ��1 b•aod;•.�d�•i +.;�roa•LL;;;��yy.;;���•yLLa;;�d�•L^.s;•.�+.��..;;.�•�y..;;:�o�•L.a;•:r•+.a.:��b�9•�a 2. FIRST AID TRAINING: To provide emergency first aid training, free of charge, to high-risk groups including seniors, single-Moms, new parents, who otherwise could not afford this training. $55 per person, based on 10 courses, 8 participants.....................$4.400.00 Instructor fees based on $11 hr. x 8 hrs. x 10 courses................... 880.00 Staff ff co-ordination $19 hr. x 2 hrs. x 10 courses........................... 380.00 `C f9 '9'vr"co oa i;tir.;oo-,a ti+:;;aoaL tiK;;•aaa,.aa'tirr.•ooSa%"x,..aaa�%,%,,v.;,asaaaK%".,%;o-%.a,•,i%,aoaaaK•�;,oa4.19x Region of Durham Branch,Office Galleria,Suite 115,419 King Streeet West,Oshawa,Ontario,Canada L1J 2K5 Telephone: (905)723-2933Noice Mail: (905)723-7251 /Fax: (905)723-9023 Ajax-Pickering Community Office-Telephone: (905)420-3383/Fax: (905)420-5557 �4" AGE> 1, CLARINGTON MEDICAL EQUIPMENT RECYCLING PROGRAM: To continue to provide a recycling depot in the Municipality of Clarington staffed by volunteers three days per week. (at present only one afternoon is possible; --------- ---------space-is-d-o-nated,-no-telephGne-i--available-far-easy-EQmmuni ation-with-our--offlce --------- and we have lost our qualified repair person, money for repairs is presenting forthcoming from the Bowmanville Rotary Club.) Telephone services, plus hook-up and installation $125 per month plus $250.00 hook-up fees...................................$1 ,750.00 Repairperson support, 5 hrs. week $ 10. hr x 52 ............................ 2,600.00 Mileage for pick-up/delivery of equipment if necessary...................... 500.00 Staff support for volunteer co-ordination $19. hr. x4x52................... 3,952.00 VY i\ `11'1'\L•.ir`1`V''"O1\4•Y''�ti•Y•.Y''''•.i•Y\r V'''�ti•1\1''V'y'�L'Y\4•V''�Li\Y`'V'''1•\\Y1'�O'�a•\\Y�O'L VI•at 4. LIFECALL PROGRAM: To provide subsidies to high-risk individuals requiring a personal emergency response devise in the Municipality of Clarington who are low-income and in need. Ten people at $30 per month x 12 months.....................................$3,600.00 Volunteer mileage for installation................................................... 200.00 • ��� � �•\\'i iv'L'�L'•\tiCv'viL•ti�Y VY''�'•1\Y�'L''1•f\YY'''�y\\Y'�Y'a'�L•1\rr^Y'i•01\Y`V �1•\\YY`V���•1tir�•Y�• ���L 5. MITTENS FOR WARMTH PROGRAM: To provide wool for volunteers to knit mittens for adults, youth and children to be distributed in co-operation with other agencies who distribute food baskets at Christmas and through-out the year. Mittens could also be made available at drop- in centres, shelters and food kitchens. Purchase of wool...........................................................................$1,000.00 Volunteer co-ordination and follow-up $19. hr. x 1 hr. x 52.................. 988.00 VAiYvae`sa'ati waaea�iweooa��tiv'soaa'iw�aoo'oa'iKweaaaz���aaaa'��waaaa�i� ooaia'�rv000ati��' i 'PAGE. 6. HOMEMAKING SERVICES PROGRAM: To provide training to 25 homemakers delivering service in the Municipality of Clarington to frail, elderly, high-risk, vulnerable clients. 'I`dFF�`�����•vae'oa�tiyci'a'bo�a�•vYoaa+i:�•voaoa�r•.•'�'ooa�iti•c�'o'oii�yv�o'oa+:rtiwa'aoiiKyvi'os 'atiro•�a'o`o� �dF9'o' 7. HOME SAFETY AUDITS: Distribute self Home Safety Audit Pamphlets to seniors in the Municipality of Clarington to promote a safe and injury free environment. 2000 pamphlets x .50.................................................................$1 ,000.00 Volunteer co-ordination $19 hr. x 4............................................... 76.00 Distribution costs (gasoline, mileage, postage, etc.)......................... 250.00 7�Oi'7�� � �'a tii sir''�'OO'hrrS''�'O'O'1►YV''�'O'h\ri L'''0'11rr'�''�'1i\YrV'�'�'041YVV''�'�'O\sir V''�'41\YVY'''O'O\irY'�'7.1itTi0�YVtl We believe our projects outlined will directly enhance the lives of the people of the Municipality of Clarington and in many instances, increase their capacity to deal with problems themselves. Your consideration to funding, in full or in part will be greatly appreciated. If you require further information or clarification, please do not hesitate to contact the undersigned at 905-723-7251 ext. 203. Sincerely, &4XIA!O /ddv Donna D. Vandertuin Attach. Branch Manager. o,t,noc,tr„yc„V,,,a„ APPLICATION #30 S,dfk ht kt&iev I,I'061.rf, Woveroriw.Suite sw Please see attached page of instructions, Sault Ste.Afarie.ontario 6A R2 — Please print or type - 1. Previous charitable gaming licence Has your organization ever applied for a charitable gaming event licence? No F�Yes(I1 yes) What is the most recent licence number issued by: - P Municipality: Have you had gaming event licences cancelled or licensing M privileges suspended in any juridication in the last two(2)years? NO F]Yes 2. Information on organization a) Incorporated or legal name GIN fi(,:bl on/ CTN>✓ c i��i2 r uc�a co i�t a A)l7-k rU u D� I I I I I Street address of organization I Cl/ 77Lt- (:vm m u ru CL/ FO u�hon,cig�S v-C+- 1 .P_,�y,,1 Province Postal de I Telephone N ). V - i � ctt7JK Fax No. Mailing address(ildilferent) i Postal Code IN o i b) Is Your organization Incorporated as a non-profit organization? n No "Yes(11 yes) e" M- -7`9 j i Jurisdiction of Incorporation number Incorporation C) is your organization registered as a Charitable Organization with Revenue Canada? 0 No L,, Yes (1I yes) Revenue Canada Reg.number X191 1 ► I 13, 'Q E d) How long has your organization existed? What is the financial year end of your organization Years tT (;� � D-� (9 4 I Month I Day 3. Affiliates fIssyyour organization affiliated with any corporation or organization? Lv��0 [_1 Yes 11 yes: List the legal Names(Attach separate sheet it necessary) a) b) 4. Use of net proceeds C 00 What will the advance funds be used for?(Attach separate sheet it necessary) ' 'moo PvotnoLL71,c rVSrdeh>�� Uhtcc fXtt't d Clot Yirvllom (,tjt/,Ci, a) v d YHn Vv'(A b) c4ILIut 46 l t 6C dicGLCcS 1 a C) U d) Questions? Call 1-800-387-0098 OLC CAP 001(ge./05) Continued on occ:( 5. Lottery trust account Name of financial institution where lottery funds are held Account number o iii Address I city ,-- 6. Unorganized Areas Is your Charitable organization located in an unorganized area? i�wo ❑Yes (11 yes,please indicate) ❑ ALGOMA UNORGANIZED ❑ PARRY SOUND UNORGANIZED E U GANIZED RAINY RIVER UNORGANIZED ❑ KENDRA UNORGANIZED ❑ SUDBURY UNORGANIZED ❑ MANITOULIN UNORGANIZED ❑ THUNDER BAY UNORGANIZED ❑ NIPISSING UNORGANIZED ❑ TIMISKAMING UNORGANIZED 7. Declaration We, the undersigned, declare that: • I/we are a Principal Officer of this organization. • I/we are NOT receiving remuneration directly or indirectly from the advance funding. • I/we have been authorized to make this application on behalf of the organization. • I/we agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. F • I/we will sponsor table game events at the local charity casino. • All answers provided in this Application, as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. P ' ci at Officer Principal Officer / Signature Print name in tuN I c 4C -r l p� Ac) (OCTOO TItie C-X EUCTI U(; T>1f245 c7Zk Business telephone number. r D ` Z 91�IS) 4I3 I — Io1310I � I I I I — ItO1 1(DI Date Signing Providing inaccurate information may render,your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire esr puss,disponiole en frongois. ,I;I THE COMMUNITY FOUNDATION OF DURHAM REGION .................................................................................................................................................. BOX 336,8 MIDTOWN DRIVE,OSHAWA,ONTARIO L1J 81-2 905-626-6565, 1-888-230-0333,FAX 905-725-2899 November 23, 1998 Ms. Marie Knight Deputy Clerk Municipality of Clarington 40 Temperance Street Bowmanville, Ontario L 1 C 3A6 Dear Marie It has been a pleasure to speak with you regarding the Advanced Lottery Funding. Further to those conversations, please find attached our application and the following related documentation: i) our governing document (letter patent) ii) Revenue Canada Notification of Registration letter iii) A detailed outline of the Clarington Community Fund —the service we provide to the residents of the Municipality of Clarington iv) Our operating budget for 1997-2000 v) Our financial statement for last year vi) The list of our Board of Directors While the application does not ask for an amount of the request, we do request $180,000. Thank you for your time in reviewing this. Should you require any further information, please feel free to call me on my direct line at 905-725-2145. Sincerely Wendy Orton Executive Director FDV 5.6.5 E THE COMMUNITY FOUNDATION OF DURHAM REGION .................................................................................................................................................. P.O.BOX 336,8 MIDTOWN DRIVE,OSHAWA,ONTARIO L1J 81_2 905-626-6565, 1-888-230-0333,FAX 905-725-2899 PURPOSE -The C�mrr�u Foundation-of-f3urham- ---- pu � Region is-to-as �poo1-of _ permanent funds whose investment revenues are used to support charitable organizations within Durham Region. There are over 81 Foundations across Canada with assets of over$1 billion. In 1997, grants made by Community Foundations topped $45 million. The Community Foundation of Durham Region holds assets and pledges of over$350,000 and gave out over$7,300 in grants in 1997. The Clarington Community Fund has been established in 1998 for the benefit of the residents and charities of the Township of Clarington. The reason The Community Foundation of Durham Region established the Clarington Community Fund was because residents of the Municipality of Clarington have told us that, while they liked the concept of a permanent fund, they wanted their donations to go to help charities in Clarington. HOW DOES THE TOWNSHIP OF CLARINGTON BENEFIT? ■ Encourages the Clarington community to become more self-reliant and less dependent on tax-related support. ■ Enables local problems to be dealt with at the local level according to priorities established in a planned manner allowing for greater community co-ordination. ■ The pooling of funds will enable greater impact in grantmaking. It keeps local capital in Clarington and helps to leverage other funds for worthy community projects. ■ Helps both small and large donors contribute to the many needs which arise in the Municipality of Clarington, both in the present and the future. ■ Acts as a savings account for charitable causes throughout the Municipality of Clarington. The Community Foundation of Durham Region does not run an annual campaign for funds but relies on donations from individuals, corporations and other organizations. From time to time, fund/awareness raising events may be held, but this is not the usual fund-raising method. WHO DECIDES HOW THE FUNDS ARE INVESTED? The guiding principle of investment for all Community Foundations is to ensure that the funds are invested in a prudent manner in vehicles that will provide a reasonable return. The Investment Committee reviews the investment portfolio on a regular basis to ensure the investments are in line with The Foundation's guidelines and governing legislation. WHAT ADVANTAGES DOES THE COMMUNITY FOUNDATION OFFER? ■ Pooling of funds. This enables a greater return on the investment ■ Permanence. The capital funds are never used up and their revenues will keep on giving back to the community in perpetuity. ■ Efficiency The Community Foundation of Durham Region offers economies of scale and expertise in both the investment of funds and the disbursement of funds to worthy causes. ■ Flexibility. Donors can designate their share of the revenues be distributed to specific charities or fields of interest, as appropriate. ■ Knowledge. Thorough knowledge of community needs, assessed by Clarington residents (Advisory Board) which results in informed granting decisions. ■ Tax exempt status. The Community Foundation of Durham Region is registered with Revenue Canada allowing the issue of tax receipts for donations. The Advisory Board for the Clarington Community Fund will review applications from local charities and recommend grant recipients to the Board of Directors. Grants are made only to registered charities, not individuals. In 1997, The Community Foundation of Durham Region funded six charities for $7,300 rtl. =° CHARITY ROSTER • ADVANCE • orri►.na7.,.r APPLICATION #31 Please see attached page of instructions. m�mrar�e,sweaao swn sa um 0VMV PU6W - Please print or typo - 1. Prevfo charitable gaming licence • • • • Has your organization ever applied for a charitable gaming event licence? [�No []Yes(if yes) What is the most recent licence number issued by: P n Municipality:M (a Have you had gaming event licences cancelled or licensing No Yes u.) privileges suspended in any juridication in the last two(2)years? 2. Information on organization GIN a) Incorporated or legal name m 8 r�tafi o I v R&socAbn Street address of organization Ci Province 40 Vi I1-re � it)C�� so, +Z-�22 Jsl-au D N Postal Code Telephone No. Fax No. LI i � 1A (7t ) 1�3G ' 104 005) 3 - 1 Mailing address(if different) Postal Code b) Is your organization incorporated as a non-profit organization? No MYes(N yes) Q2 Jurisdiction of Incorporation number ��� J I Incorporzt cn c) Is your organization registered as a Charitable Organization with Revenue Canada? No Yes(If yes) I i (� O (p g t Revenue-Canada Req.number �1 d) How long has your organization existed? What is the financial year end of your organization � j Month Da� Years 3. Affiliates Is your organization affiliated with any corporation or organization? "X No Yes If yes: List the legal Names(Attach separate sheet if necessary) a) b) 4. Use of net proceeds What will the advance funds be used for?(Attach separatesheet if necessary) a)a(, ►(�rr`(L4 b) C) d) Questions? Call 1-800-387-0098 otc CAP 00 1(98+05) Y :. Continue S. Lottery trust&=cunt Nuns of fin3ndal ftftftn whom to"funds am held Account number ��e( (D Addms 6. Unorganized Areas Is your Charitable organization located in an unorganized area? 'A No ❑Yes(if yes.please indicate) 'A NO UNORGANIZED Fj PARRY SOUND UNORGANIZED UNORGANAZEO RAINY RIVER UNORGANIZED _____ ______ ® KENDRA UNORGANIZED SUDBURY UNORGANIZED MANITOULIN UNORGANIZED THUNDER BAY UNORGANIZED ® NIPISSING UNORGANIZED C] TIMISKAMING UNORGANIZED 7. Declaration We.the undersigned.declare that: • Itwe are a Principal Officer of this organization. • Itwe are NOT receiving remuneration directly or indirectly from the advance funding. • Itwe have been authorized to make this application on behalf of the organization. • Itwe agree to deposit all advance funding into the designated lottery trust account. • I/we agree to use the advance funding for approved charitable purposes only. • Itwe will sponsor table game events at the local charity casino. _ • All answers provided in this Application.as well as all the information contained in the documents and materials submitted with it are true and complete. We have read and understand the entire Declaration above. Principal Officer Principal Officer Signature . /f Print tame in tall, Title ° l° ) Z-1 d I I - 1 71 �I L Ba:iness telephone number r t t{ t 31,° I �C)VJper tqq Date Signing 01� —16 Providing Providing inaccurate information may render your organization ineligible for advance funding Questions? Call 1-800-387-0098 Ce formuloire est oussi disponible en fr ONTARIO PROVINCIAL OFFICE 573 King Street East, Suite 201 THE LUNG ASSOCIATION Toronto, Ontario N15A 4L3 t Tel: (416) 864-9911 Fax: (416) 864-9916 Website: http://www.on.lung.ca Question 4. Use of net proceeds. a wi advanced funds Ue usedTor. The Lung Association is among the oldest charitable, voluntary health organizations in Canada, established in 1900. Originally founded to stop the spread of tuberculosis, The Lung Association now raises funds for research and health promotion programs related to respiratory disease, asthma, environmental health, smoking prevention and cessation. One in five Canadians suffer from a breathing problem. In Clarington, that is almost 12 000 individuals. Our work in the community focuses on the prevention of lung disease and on providing valuable information and support for people suffering from lung disease. Through our printed information, web site and direct contact with people, we aim to help people with chronic lung disease and their care givers gain a greater understanding of their condition so that they may improve their quality of life. Recently we carried out research with asthmatics in order to understand their needs. We found that asthmatics are looking for a clear, concrete, trusted source of support and information. Armed with this valuable information, we are now involving asthmatics and health professionals in the creation of a new asthma strategy that will include an asthma management program as well as a helpline for asthmatics to call to receive education and counselling about their asthma. The program and helpline are designed to provide asthmatics and their caregivers with the information and skills necessary to improve the management of their asthma. We also intend to share the knowledge we have gained from this research with health professionals such as doctors, nurses, respiratory therapists and pharmacists so that they may have a greater understanding of their asthmatic patients. The funding we are seeking from the Advanced Funding Program would go to the delivery of the new asthma strategy in Clarington. We are requesting $25,000.00. The Clarington office of The Lung Association, located at 40 King Street West, Suite 202, in Oshawa, is one of 33 community offices in the province. The professional sections of our organization include the Ontario Thoracic Society (primarily doctors specializing in respiratory health) and the Ontario Respiratory Care Society (other allied health care professionals such as nurses, respiratory therapists, physiotherapists and pharmacists with a special interest in respiratory health). Program development and implementation is extremely effective when we combine the patients' needs with the expertise of the health professionals in our societies along with our community office base. It is a formula for success. We plan to use this formula for the development and implementation of the asthma strategy in Clarington. When YOU Can't Breathe, Nothing Else Matters. Charitable Registration No. 12404 6368 RR0002