Community Grant Reimbursement Request

All funded projects/programs must complete the following 2 pages in order to receive payment from familiesforward.

Send completed forms and receipts to:

familiesforward, 465 Stafford St., Winnipeg MB R3M 2E2

Or email documents to familiesforward@swfic.org

Project/Program Name: Click here to enter text.

Name to appear on cheque: Click here to enter text.

Please list all receipts with a short description (i.e. books, games, snack, wages etc…) Attach copies or originals.

Vendor	Description	Amount
total spent	0

*** Only items listed on your grant item are eligible for reimbursement.

Reminder a 10% holdback will be held until your organization participates in/attends a familiesforward coalition meeting/event. Contact Coordinator for options.

Healthy Child Manitoba (our funders) require the following information about all parent-child coalition funded programs. Please complete the following:

Program/Activity Name: Click here to enter text.

Sponsoring Organization: Click here to enter text.

Program Type: (please check all that apply)

☐Community Capacity	☐Learning and Literacy

☐Nutrition and Physical Health	☐Positive Parenting

What was the target group of your project/program (please check only one)

☐ Parent and Child	☐Preschool (ages 0-5)	☐ Parents Only

☐Community	☐ Other (please specify: Click here to enter text.

How many people did this serve?

Click here to enter text.# of Children	and/or Click here to enter text.# of Families

Please describe your project/program. (2-3 sentences)

Click here to enter text.

Please describe your project/program outcomes. (2-3 sentences)

Click here to enter text.

Thank you for your collaboration on this matter. Reimbursements will be issued by cheque from South Winnipeg Family Information Centre on behalf of familiesforward. Reimbursement timing is contingent on receipt by familiesforward of the operating grant from Healthy Child Manitoba.

Questions? Please contact our Coordinator anytime.
familiesforward@swfic.org or 204-791-0956