Application Form | Shevchenko Foundation

Application Form

Self-Defined Arts & Heritage Projects for Displaced Ukrainian Adults

Name of Organization(Required)

Charitable Number (if applicable)

Name of Contact(Required)

First Last

Position held in Organization(Required)

Organization Mailing Address(Required)

Street Address City Province Postal Code

Email of Contact(Required)

Home Phone(Required)

Other Phone

Organization website

Please attach the following supporting documentation:

a letter of intent stating the nature and goal of the project, and the names of the participants;
latest financial statement adopted by AGM;
a project budget stating income and expenses.

Attach files(Required)

Drop files here or

Accepted file types: pdf, txt, doc, docx, Max. file size: 128 MB, Max. files: 5.

Declaration - Check all that apply

I confirm that the statements and financial information in this application are true

I accept the eligibility conditions and application requirements of this program and agree to abide by the funding decision of the Shevchenko Foundation.

I will use the grant funding for the approved purpose

I understand that the Shevchenko Foundation is subject to the Freedom of Information and Protection of Privacy Act and the above information is protected under the Act.

I agree to indemnify and hold harmless the Shevchenko Foundation, including its employees and contractors.

I will acknowledge the Shevchenko Foundationin all promotion, publicity, and marketing materials related to this funding assistance.

Name(Required)

Position in Organization(Required)

Signature(Required)

Date(Required)