EASTERN ONTARIO SQUARE AND ROUND DANCE ASSOCIATION
REQUEST FOR FINANCIAL ASSISTANCE
Name and Address of the individual or Group:
Telephone Number: ( ) _____ - ________ Email: ___________________________________
A: Has a detailed business or work plan been developed? Yes____ No____
B: If 'Yes", Please attach a copy; If 'No', please attach a statement of how you intend to proceed to
accomplish your goal. Your statement should include as much details as possible concerning
costs, time frames, activities that will be undertaken in order to achieve your objectives.
C: No funds will be advanced until the completion of your project, and only after this Board has
reviewed the results. Therefore a complete financial report, with receipts, must be attached
to your final submission.
D: The amount to be reimbursed to you or to the Orgainzation shall be up to 50% of your net costs
to a maximum of $ 250.00 per club or $200.00 per individual.
Signed: ___________________________________________ Date: ___________________