COVID-19 Emergency Community Support Fund (ECSF)

United Way of Sarnia-Lambton is pleased to provide support to local community service organizations that provide rapid, emergency community support to vulnerable community members. Theses funds are being distributed as part of Employment and Social Development Canada's Emergency Community Support Fund.

Charities and other Qualified Donees (included registered charities) are eligible to apply. This includes maintaining a volunteer Board of Directors that meets regularly, host an Annual General Meeting, have financial statements that have been audited by a licensed public accountant or, for those with annual revenues less than $100,000, a financial review. Organizations may seek ECSF funds acting alone, or as part of a partnership. Organizations may also seek funds for more than one service. Separate requests must be completed for each service.

The ECSF will provide financial support for local community services that:

- Address a pressing social inclusion or wellbeing need caused or worsened by COVID-19

- Service one or more vulnerable groups (defined below)

- Will be carried out with a reasonable budget before March 31st, 2021

Vulnerable Populations as defined by ESDC include:

Marginalized Communities including; Racialized communities, Indigenous peoples, Official Language Minority communities, Other linguistic minorities, Newcomers, Women and girls, LGBTQ2S+ communities

Children, Youth, and Elderly, including; Children and Youth: all, aging out of care, ages 0 to 18, and ages 19 to 29, Post-Secondary Students, Seniors and Elders: not in care, and living in care

Workers Who are Vulnerable, including; Essential Workers, Temporary Foreign Workers, Workers in the informal labour market, Caregivers

Populations Requiring Special Care or Supports; People experiencing homelessness, People with low income or living in poverty, People living with mental illness, People struggling with addiction, Persons with disabilities, People experiencing domestic or gender-based violence, People living in group homes or supportive living (under the age of 55), Prison populations (detained and incarcerated), Veterans

Please note: You may not apply for the same activities that you have already received funding for from the Government of Canada or other source, including Community Foundations, Canadian Red Cross, or United Way.

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* 1. Organization Name & Charitable Registration Number

Name:

Charitable Registration Number:

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* 2. Name of Program being applied for:

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* 3. Contact Information of Applicant

Individuals Name:

Title:

Phone Number:

Email Address:

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* 4. Organization Address(s)

Street Address:

Mailing Address:

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* 5. Briefly description of programs, client base, etc. that this funding will assist.

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* 6. Service Dates:

Proposed Program Start Date:

Proposed Program End Date:

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* 7. Vulnerable Populations Served. Please choose all that apply:

Children and Youth ageing out of care

Children and youth ages 0 - 18

Children and youth ages 19-29

Seniors and Elders not in care

Seniors and Elders living in care

People experiencing homelessness

People with low income or living in poverty

People living with mental illness

People struggling with addiction

Persons with disabilities

People experiencing domestic or gender-based violence

People living in group homes or supportive living (under age of 55)

Prison populations (detained and incarcerated)

Veterans

Indigenous People

Racialized Communities

Members of LGBTQS+ Communities

Newcomers

Essential Workers

Temporary Foreign Workers

Workers in the informal labour market

Official Language Minority Communities

Other Language Minority Communities

Caregivers

Students (post-secondary)

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* 8. Please list a minimum of three program outputs for tracking (eg. # of meals provided, # of financial counselling sessions provide, # of homeware visits provided, # of medical item deliveries, # of shelter nights provided, # of virtual social activities provided, # of persons transported etc.)

Output

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* 9. How will this program help and benefit the populations identified above? (maximum 250 words)

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* 10. How many unique individuals do you anticipate serving?

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* 11. How many service interactions do you anticipate providing?

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* 12. How do you know this is needed in relation to COVID-19? (maximum 250 words)

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* 13. Is this an existing service?

Yes

If yes, how many additional people does the service anticipate reaching as a result of this application?

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* 14. Is this program being delivered by a partnership of agencies in our community?

Yes

If yes please list the other partner agencies.

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* 15. Will this service engage the support/involvement of Canadian Businesses?

Yes

If yes please explain how.

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* 16. Situation(s) and needs this funding will address. How many clients do you anticipate to be Rural vs Urban?

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* 17. Amount of Funding requested

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* 18. Tentative Budget

Proposed Income:

Federal Government Sources (specify)

Provincial Government Sources (specify)

Municipal Government Sources (specify)

United Way (proposed in this application)

Corporate / Donor Support

Sarnia Community Foundation

Canadian Red Cross, Sarnia-Lambton

Other United Ways in the area

Other Community Partners (specify)

Any other income sources (specify)

Total Income:

Proposed Expenses:

Wages and Benefits

Disability Supports for Staff

Professional Fees

Travel and Accommodations

Materials and Supplies

Printing and Communications

Equipment Rental/Lease/Maintenance

Administration Costs

Capital Costs (specify)

Total Expenses:

Income/(Loss):

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* 19. Do you accept direct deposit payments?

Yes

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* 20. What will your Agency do to promote receipt of funding from the United Way and Employment & Social Development Canada?

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* 21. I declare the information provided in this application to be accurate and complete and complex with the eligibility criteria found in the guidelines. (If information is found to be inaccurate, in part or in whole, funding could be withdrawn.)

Yes