Program for the Enrichment of French in Education GRANT APPLICATION FORM 2016–2017 Please save completed form and submit the application by January 15, 2016. For further information, please visit the website http://www.edu.gov.mb.ca/efe/index.html or contact Danielle Parent at 204-945-6024, or toll-free at 1-800-282-8069, ext. 6024, or by e-mail at palo-olsp@gov.mb.ca. INFORMATION ABOUT THE APPLICANT 1. Legal Name of Organization 2. Address 3. Name of President or Executive Director 4. Legal Status (provincially or federally incorporated) Registration Number: 5. Name of Project Head Title Phone Fax E-mail address INFORMATION ABOUT THE APPLICANT 1. Project Title 2. Length From: To: 3. Previously Funded 3.1 Has this project previously received funding from this program (PEFE)? No (please proceed to question 4) Yes (please answer the following questions) 3.2 Were the performance targets from the last application achieved? If Yes, please specify. Application Form 2016-2017 Page 1 If No, have you changed your performance targets or what changes have you made to your project in order for the targets to be achieved? 4. Educational Community Need 4.1 What need on the part of the educational community will this project meet? 4.2 What steps have been taken to confirm this need? Please explain what you have done (surveys, consultations, observations, conversations, etc.) and with whom (students, teachers, principals, etc.). 5. Project Description Describe the project in 250 words or less (timeline, location, main activities, target clientele, partners, etc.). Application Form 2016-2017 Page 2 6. Educational Objectives 6.1 Explain how this project will contribute to achieving the educational objectives of the PEFE (see Selection Criteria on the PEFE web page.) 6.2 What impact will this project have on the educational community (students, teachers, etc.)? 6.3 Does the project make curriculum connections? If so, explain. 7. Educational Areas Please select the educational area or areas targeted by your project. (Projects that do not target one of these areas will not be considered.) ENRICHED SCHOOL ENVIRONMENT (strengthen and promote French language learning through schoolbased, extra-curricular, and post-secondary activities; promote and provide access to Francophone culture, bring the Francophone and school communities closer together; upgrade the linguistic skills of students from the minority community, facilitate the francization of adults, etc.) STUDENT RECRUITMENT AND RETENTION (promotional activities, activities in French for the community's parents, etc.) 8. Targeted Population and Number of Individuals to Benefit from the Project Students Français Program French Immersion Program French Course (English Program) Pre-School Elementary (K–8) Senior High (9–12) Application Form 2016-2017 Page 3 Teachers Français Program French Immersion Program French Course (English Program) Elementary (K–8) Senior High (9–12) Other – Specify: 9. Performance Targets and Project Evaluation 9.1 Identify the performance targets as they relate to the need identified at 4.1 and the educational objectives of the PEFE. E.g.: number of participants, percentage of time that the students have interacted in French, degree of commitment, level of satisfaction, etc. 9.2 How will achievement of the performance targets be measured? Please provide the evaluation tool. E.g.: survey, testimonial, rating scale, etc. Application Form 2016-2017 Page 4 PART C — TOTAL BUDGET FOR THE PROJECT Describe the nature and amount of estimated expenditures, from July 1, 2016 to June 30, 2017, for each of the categories below. Expenditures Amount Estimated Expenditure Details (required) Wages (positions filled by salaried employees, amount of wages and benefits for each, etc.) Amount Requested* $ $ $ $ Fees (audits and professional services, such as artistic performances, consulting, etc.) Operating Costs (rentals, insurance utilities, telephone, stationery, etc.) Project Materials and Supplies Transportation Meals and Accommodations Advertising (publication of brochures, posters and media advertising, etc.) Other TOTAL EXPENDITURES** Revenue Sources (A) Revenue Details (required) Total Direct Revenue $ (tuition fees, sales, dues, funds collected, subscriptions, etc.) Contribution from Organization $ Other (all other possible sources of funding from other levels of government, other provincial departments, foundations, etc.) $ Program for the Enrichment of French in Education $ (Indicate total amount requested.) TOTAL REVENUE** (B) $ * Provincial funding will not exceed 50% of the actual cost of the project. ** Please note that the TOTAL REVENUE (B) must equal the TOTAL EXPENDITURES (A). Application Form 2016-2017 Page 5 PART D — CONDITIONS Assistance provided under the Program for the Enrichment of French in Education must be used solely for the purposes set out in the application. Once funding has been approved by Manitoba Education and Advanced Learning ("the department"), no major changes may be made to activities without its approval; moreover, what constitutes a major change in any particular case shall be determined by the department. All funds not used for the above-mentioned purposes must be reimbursed to the provincial government. The organization receiving a financial contribution must provide recognition through the use of the "Canada" and "Manitoba" wordmarks for the federal and provincial governments and, where space and circumstances allow, specific text that refers to the Government of Canada and Government of Manitoba. The organization is entirely responsible for its debts. The department shall not consider any application made for the purpose of paying debts. If a portion of the funding is to be used to pay salaries or fees, federal and provincial legislation concerning salaries and deductions (e.g., taxes, employment insurance, etc.) must be observed. The organization is required to keep an accounting of all revenue and expenditures. In addition to the financial statements required at the end of each fiscal year, the organization may be asked to provide supplementary information and supporting documents by the provincial or federal governments. Auditing and monitoring the projects are an integral part of the funding process. The organization must agree to respect the spirit and the letter of The Human Rights Act and the Official Languages Act. Under the Access to Information Act, the public may request and obtain information contained in federal and provincial government files. In the event that an application for information concerning this application for funding is received, the department will consult the organization before any information is released. It is important to point out, however, that only personal information and some confidential financial information concerning a third party may be withheld. Once funding has been approved, the amount, the purpose for which it is granted and the name of the organization can be released to the public. The department will notify organizations in writing about the results of their application for funding under the Program for the Enrichment of French in Education as soon as a decision is reached by the Province of Manitoba. The timelines and instalment schedule are as follows: Application Project analysis Deadline: January 15, 2016 February–May 2016 Response to applicants June 2016 First instalment – 50% Fall 2016 Interim Report Deadline: January 31, 2017 Second instalment – 30% March 2017 Final Report Third instalment – 20% Deadline: September 15, 2017 Fall 2017 Application Form 2016-2017 Page 6 PART E — CERTIFICATION I CERTIFY THAT: The information in this application is accurate and complete. This application is made on behalf of and with the approval of the organization whose name appears on page 1. If funding is granted, the said organization agrees to provide financial statements and activity reports in accordance with the requirements of the department. If funding is granted, the said organization will comply with the legislation and the directives of the department regarding the accounting of public funds. If funding is granted, the said organization is aware that the Auditor General, in accordance with Section 17 of the Auditor General Act, may request additional information and explanations necessary to fulfill the auditor's responsibilities or may perform a financial audit of the project. Name of person authorized to sign (President or Executive Director) Name Title Signature Date PART F - SUBMIT APPLICATION Please e-mail an electronic copy of the application to: palo-olsp@gov.mb.ca In addition, send a signed copy, along with additional documentation, to: Danielle Parent, Education Officer Program for the Enrichment of French in Education Manitoba Education and Advanced Learning Bureau de l'éducation française Division 509–1181 Portage Avenue Winnipeg, Manitoba R3G 0T3 Fax: 204-945-1625 Application Form 2016-2017 Page 7