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                             (for Francophone Communities)

                             APPLICATION FORM
To complete this form, it is important that applicants read and follow the information in the How
to Apply section on this site. As indicated in that section, in addition to the form below,
applicants need to submit supporting documentation that substantiates information provided in
this application form.

The following information must be provided in the proposal (along with other documents listed
in the Application Checklist.

Please remember to save your application periodically to ensure all of your information is saved.
We encourage you to contact the designated officer in your region to discuss your application.


 TYPE OF BUSINESS (e.g. main product or

 KEY OFFICERS/CONTACT PERSON:                         Mr.        Mrs.       Ms.         Blank
 Name:                                             Telephone Number: (          )   -
 E-mail Address:                                   Fax Number: (        )   -
 PRESIDENT /CHAIR/ MAYOR:                             Mr.        Mrs.       Ms.         Blank
 Name:                                             Telephone Number: (          )   -
 E-mail Address:                                   Fax Number: (        )   -
 DIRECTOR / GENERAL MANAGER /                         Mr.        Mrs.       Ms.         Blank
 Name:                                              Telephone Number: (           )   -
 E-mail Address:                                    Fax Number: (         )   -
 TREASURER/BOOKKEEPER:                                  Mr.        Mrs.       Ms.         Blank
 Name:                                              Telephone Number: (           )   -
 E-mail Address:                                    Fax Number: (         )   -

1.1    History of the Organization/Association

Brief history, including any relevant historical event (e.g. by whom, when, and where
organization/association was established; changes in ownership, reorganization, proposal(s) to
creditors or bankruptcy).

1.2    Mandate of the Organization/Association

As outlined in the legal documents which establish the organization. Enclose copies of
documents of incorporation as a not-for-profit corporation.

1.3    Organization/Association Profile

Brief description of the organization (number of staff and/or membership, office location (s), its
activities, key markets, products/services, catchment area, and other characteristics).

1.4    Officers/Key Employees

Identify officers and key employees, indicating their role within the organization, responsibilities,
experience and qualifications related to this project.

1.5    Partner Information

Identify all contributing partners to this project (financial or otherwise) and describe how they
support the project activities.
1.6    Key References

Provide name, address and telephone number of key references for the organization/association,
including Bank Manager, Accountant, Solicitor and Insurance Agent.


2.1    Detailed Project Description:

Provide a full description of the project.

2.2    Project Objectives:

Specify objectives to be achieved by the project and critical issue(s) that the project will resolve.

2.3    Performance Targets:

Indicate how the project fits with the strategic objectives of the Economic Development Initiative
- Roadmap for Canada’s Linguistic Duality, to support business and economic development
initiatives that encourage sustainable growth in Ontario’s Francophone communities by focussing
on two strategic priorities (choose one):

               Community Strategic Planning
               Business and Economic Development


2.4    Describe how the project will support the following EDI National objectives (choose one
       or more of the following):

               Capacities Built
               Enterprises Developed
               Communities Developed

2.5    For Community Strategic Planning projects, describe the planning process that led to the
       identification of this project as a priority of the Francophone community.

2.6    For Business and Economic Development projects, indicate how the proposal responds to
       a priority and need of the Francophone community as identified in a local, regional or
       provincial strategic and/or community plan (identify the plan).

2.7    Methodology/Timing:

                                                          Day        Month             Year
 Project Start Date:

 Project Completion Date

Identify key workplan activities and project timelines.

2.8     Geographic Location

 The project will impact the Francophone Communities located in
                                                                             Yes        No
 (please refer to the map provided on the contact list):
 Northwest region
 Northeast region
 Southwest region
 Southcentral region
 Southeast region

Please identify which Francophone communities this project will impact:

The project will have provincial or National impact:

2.9    Consultant Services:

If consulting services will be used, attach:

               Terms of Reference for the Study (final)
               List of candidate consulting firms
               Request for Consultant Proposals (draft or final)
               Consultant’s Statement of Work (if consultant has been selected)

3.1    Identify detailed project costs using the project budget template provided on the Web site

3.2    Substantiate detailed project costs provided in the budget information.

3.3    Outline proposed financing arrangements, provide documentation to confirm
       commitments from funding partner(s) or to indicate the status of such funding requests.

3.4    Using the template provided on the site, provide a cost forecast for the project, clearly
       indicating expenditure and revenue streams.

3.5    Demonstrate need for assistance. Enclose copies of financial statements for the last two
       years and the most recent interim financial statement.

3.6    Demonstrate need for cash advance provisions (if applicable).
3.7    Where project generates revenue from operations, state preferred repayment schedule (if

4.1    Identify anticipated economic benefits to the Francophone community both during and
       following the term of the project as it relates to:

 # jobs created (direct)
 # jobs maintained (direct)
 How many are permanent
 How many are temporary
 How many are full time
 How may are part-time or seasonal

 Jobs created                    Jobs created in a new or an existing business/organization
                                 Jobs maintained in an existing business/organization that has
 Jobs maintained                 generated sales/had activity (more than one year of operation)
                                 in order to maintain a sustainable level of activity
                                 A job expected to last five years or more (based on best
 Permanent Job
                                 Count all jobs created to complete the project (e.g.
                                 contractors, staff people, project managers), regardless of how
                                 much FedNor contributed or which particular activity was
 Temporary Job                   supported.

                                 Also, all jobs created, as a result of the project, which are
                                 expected to last less than 5 years.

 Full Time                       Works 30 hours or more per week/1560 hours or more of
                                 work per year
                                 Less than 30 hours per week/less than 1560 hours of work per
 Part-Time or Seasonal
4.2    Identify other anticipated economic benefits (if applicable).


5.1    Outline any sensitive issues or risks which may be associated with the project, including
       potential criticism from competitors.

5.2    Indicate whether and how the project is complementary to other related initiatives.

5.3    Identify impacts the project could have on other Ontario and Canadian businesses,
       organizations, institutions or communities.


6.1    Identify individuals/organizations which have been consulted on this project (e.g.
       Francophone organizations involved in the sector, bilingual organizations that serve the
       Francophone population, Community Futures Development Corporations, Province,
       Economic Development Officers), and indicate their position. Letters of support may be
       attached. Please provide telephone number and email address of individuals/organizations
       which have been consulted on this project.


Any application not signed by the proper authority of the organization cannot be processed.
The undersigned certifies that all information provided to FedNor in support of this request for
funding is true and complete, and undertakes to provide any further information that may be
required for FedNor to render a decision, in a timely manner.

The undersigned also herewith provides consent tor FedNor to make sufficient credit and other
enquiries that may be necessary in the evaluation of this request for funding.

The undersigned also certifies that no additional funding has been applied for in regards to this
project; and,

that the Applicant (organization or firm) is current on all obligations to the Government of
Canada under agreements for other financial assistance; that the execution of the proposed
project will not prevent the applicant from continuing to meet these obligations and from
maintaining the economic benefits anticipated by the other agreements; and that these obligations
will not preclude the applicant from fulfilling its obligations under the proposed project.

Signed this _________ day of ________________, _________.

Signature (Officer with signing authority for the Organization)


Confidentiality: No commercially confidential information which you submit to us will be
disclosed unless otherwise specified by you; required to be released by law; or required by the
Minister of Industry to be released to an international or internal trade panel for the purposes of
the conduct of a dispute in which Canada is a party or a third party intervener. Information on the
federal government's Access to Information Act is available on the following Web site:
Any information that you wish to be considered as confidential should be annotated accordingly.

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