Application for funding
Completing the form
This is a standard form used by Accessibility Standards Canada
You must read the Applicant Guide related to the program information on how to complete and submit this form. Each funding program may have different:
eligibility requirements
priorities, or
supporting documents to send with your Application Form.
You must complete all parts of the Application form, unless the guide or the form tell you not to. Accessibility Standards Canada can refuse applications that are missing information or have errors.
This document includes these sections:
Notice to applicants
Part 1 – Organization
A. Organization
B. Organization contact info
C. Organization capacity
Part 2 – Project proposal
A. Project ddentification
B. Project description
C. Project details
Part 3 – Funding
A. Anticipated sources of funding
B. Budget
C. Budget details
Part 4 – Attestation
Appendix A
How to submit the form and supporting documents Read the Applicant Guide for instructions. The guide will tell you how to submit your application and your supporting documents.
Notice to applicants Attestation
To be eligible, you must have the authority to:
submit project proposals for the applicant organization, and
enter into contracts and agreements or this organization
Checking the 3 boxes in Part 4 of the form, means the information in the application and supporting documents is:
true
accurate, and
complete
You must provide:
your name
your title, and
the date
No signature is needed.
Information in the form Completing this application form is voluntary. We will use this information to assess your project.
We may also use or share your application information:
for policy analysis
to do some research
for evaluation
to discuss with other relevant government of Canada departments or federal organization to assist with project evaluation. For example, it may help to decide if the project addresses a gap or focuses on relevant topics.
to share information with others outside the government as a part of the review process.
These other options for using or sharing personal information will not affect your relationship with this department or any other government organization.
Personal information
We make sure to manage personal information outlined in :
the Privacy Act, and
other relevant laws
You have the right to:
access your personal information
ask to make corrections if you think there is an error or something is missing.
Questions, concerns, or complaints about how the Privacy Act and privacy policies are applied can be sent to the Accessibility Standards Canada's Privacy Coordinator:
Accessiblity Standards Canada Privacy Coordinator
If you are not happy with our response to your privacy concern, contact the Office of the Privacy Commissioner of Canada .
Access to information
After this process, the information on the successful applications will be available on Open Government
Your application is also subject to the Access to Information Act (ATIA). The ATIA gives every person a right to access information under the department’s control, except for some exemptions .
Find instructions for accessing this information here . You can also visit a Service Canada Centre.
Part 1 - Organization
A. Organization identification
1. Legal name
(required)
2. Operating (Common) name (if different from legal name)
3. Business or registration number
(required)
4. Organization type
(required)
5. Organization category
(required)
6. Year established
7. Organization address
(required)
8. City or town
(required)
10. Country
(required)
11. Postal code
(required)
12. Telephone number
(required)
13. Fax number
14. Email address
(required)
15. Mailing address (mandatory field if different from Organization address)
16. City or town (mandatory field if different from Organization address)
18. Country (mandatory field if different from Organization address)
19.Postal code (mandatory field if different from Organization address)
20. Telephone number * Ext (mandatory field if different from Organization number)
21. Fax number
22. Organization's mandate
(required)
B. Organization contact
Primary contact - This should be your primary contact person with respect to this application for funding.
23. Given name
(required)
Surname
(required)
24. Position title
37. Preferred language of communication
26. Organization contact - address
(required)
27. Contact address (mandatory field if different from Organization address)
28. City or town (mandatory field if different from Organization address)
30. Country (mandatory field if different from Organization address)
31. Postal code (mandatory field if different from Organization address)
32. Telephone number * Ext (mandatory field if different from Organization number)
33. Fax number
34. Email address
Secondary contact
35. Given name
Surname
36. Position title
37. Preferred language of communication
38. Organization contact - address
39. Contact address (mandatory field if different from Organization address)
40. City or town (mandatory field if different from Organization address)
42. Country (mandatory field if different from Organization address)
43. Postal code (mandatory field if different from Organization address)
44. Telephone (mandatory field if different from Organization number)
45. Fax number
46. Email address
C. Organizational capacity
47. How many employees does your organization currently have?
If ‘Yes’ please provide a description of the changes
49. Please describe how your organization has the experience and expertise to carry out the proposed project activities.
(required)
Part 2 - Project
A. Project identification
52. Project title
(required)
53. Planned project start date (yyyy-mm-dd)
(required)
54. Planned project end date (yyyy-mm-dd)
(required)
B. Project description
55. Project objectives (must be clearly linked to the objectives of the program to which you are applying).
(required)
56. Project activities (must be broken down into clear steps)
(required)
57. Expected results of the project (must be clearly linked to the project objectives and be specific, concrete and measurable).
(required)
If ‘Yes’, please describe how you will meet and track the expected results of the project
If ‘Yes’, please describe how
If ‘Yes’, please include your main address and an address for every other location where project activities will occur
If ‘Yes', please provide an explanation and any details on whether consultations will take place with these communities
If ‘Yes’, please clearly identify the role(s) and expertise they will bring to the project
If ‘Yes’, please select all that apply
64. Does your project include activities that are listed in the Impact Assessment Agency of Canada (IAAC) Regulations Designating Physical Activities established under the Canadian Impact Assessment Act 2019
If ‘yes’, then, as per the Canadian Impact Assessment Act (2019), you must submit your project description electronically to the IAAC for further review. The IAAC will determine if an IA is required based on your project description. Accessibility Standards Canada funding will be conditional upon receipt by the department of, as the case may be, IAAC confirmation that an IA is not required, or, a copy of the completed IA and confirmation that your organization is equipped to appropriately address the IA findings.
Part 3 - Funding
C. Budget details
You have to use a period for decimal points. Commas will not be recognized.
74. Associated businesses or individuals: Please check all statements below that apply to your planned expenditures of Accessibility Standards Canada funding:
If yes, please explain the benefit of the purchase that are necessary to carry out the project activities
76. Further budget details: Budget breakdown by fiscal year, and detailed by project activity and cost category.
(required)
PART 4 – Attestation
For your application to be eligible, the official representative who has the capacity and the authority to submit project proposals and enter into contracts and agreements for your organization must confirm these statements:
(required)
(required)
(required)
