Application Form

    Personal Profile:

    Self identification of Indigenous or minority status (confidential):




    Organization Profile (if applicable):


    Mailing Address:

    Role of person applying for the funding within the organization:

    Which community will benefit from this initiative?

    Which community wellness program are you applying for?

    What is the name of your initiative? If no name provide a brief description.

    How will the above community benefit from this initiative?

    Do you have additional funding in place? If yes, please list in comment box:

    What is the primary need for funding?

    What is the secondary need for funding?

    What is the total budgeted cost for the initiative? Comment box/add attachment (mandatory)

    What is the impact of this imitative on the youth and elders in the community?

    Are there potential barriers or impacts with this initiative if Weaving Roots Foundation is unable to provide funding assistance?

    Optional Item: Upload any supporting documents for the initiative, brochures etc...

    Discovering Potential Through Opportunity