Please read these guidelines before completing the application on the reverse side!

Mission CultureKids Fund

Guidelines for CultureKid GrantsGuidelines for CultureKid GrantsGuidelines for CultureKid GrantsGuidelines for CultureKid Grants • Grants to INDIVIDUALS are designed to sup-

port children & youth whose arts & cultural op-portunities are financially limited.

• A maximum grant of $250 is allocated to

each child or youth in a calendar year. • Children under the age of 18 are eligible for a

grant. • Grants are for registration fees to an arts or

cultural program. • Travel expenses and camps are not eligible ex-

penses. • The organization must be a recognized arts &

cultural service and approved by the Mission Parks, Recreation & Culture Department.

How the Process WorksHow the Process WorksHow the Process WorksHow the Process Works • An adult applicant initiates the application on

behalf of a child. • The adult applicant completes parts 1, 2 & 3 of

the application form. • The adult applicant then forwards the applica-

tion to the Adjudicator who is familiar with the applicants financial situation. The Adjudicator must be a professional in the community (I.e. teacher, principal, counselor, banker, lawyer, social worker etc.)

• Arts & Culture Instructors, directors of clubs, co-

workers, or family members are not accepted as Adjudicators.

Enhancing extracurricular activities for children & youth.

Return Application to:

Mission CultureKids Fund c/o Mission Parks, Recreation & Culture 7650 Grand Street Mission, B.C. V2V 3T3 Phone: (604) 820-5350 Fax: (604) 826-4396

So ALL Kids CanSo ALL Kids CanSo ALL Kids CanSo ALL Kids Can

Experience Culture!Experience Culture!Experience Culture!Experience Culture!

Mission CultureKids Fund is supported by:

________________________________________ Participant’s Name

_______________________ ________________________ Birth date Age

__________________________________________________ Address

_______________________ ________________________ City Postal Code

_____________________ ________________________ Telephone Arts & Cultural activity

__________________________________________________ Duration of program

$ _____________________ $ ______________________ Full cost of registration Grant $ allocated

________________________________________ Program / Organization

__________________________________________________ Address

_______________________ ________________________ City Postal Code

_______________________ ________________________ Contact Position

__________________ ___________________ Telephone Fax

__________________________ __________ Adult Applicant Telephone __________________________________________________ Relationship to child/youth: (Parent, Teacher, Friend etc.)

__________________________________________________ Address

_______________________ ________________________ City Postal Code I agree to the best of my knowledge that the above information is accurate.

________________________________ ________________

X Signature Date

__________________________ _____________ Adjudicator Position

________________________________ ________________ Organization Telephone

________________ ________________________________ Fax E-mail

__________________________________________________ Address

_______________________ ________________________ City Postal Code

I thoroughly read and understand the guidelines and believe this request to be consistent with the KidSports FundTM. I agree to deliver the cheque to the athlete recipient or his/her adult applicant and I agree to participate in a brief telephone follow up apon request.

________________________________ ________________

X Signature Date

♦ Please read the CultureKids

guidelines on the reverse

side before completing this

application

♦ All 4 sections of this page

must be completely filled in

before it is returned for

processing.

♦ After parts 1, 2 & 3 are

completed, the Adult

Applicant passes the form

on to an Adjudicator who

will complete the form and

submit it to the

CultureKids Fund.

Application Number

Adult Applicant

Adjudicator

CultureKids Fund

Return Application to:

Mission CultureKids Fund c/o Mission Parks, Recreation & Culture 7650 Grand Street Mission, B.C. V2V 3T3 Phone: (604) 820-5350 Fax: (604) 820-4396

See reverse for more information.

Mission CultureKids Fund