Application form for policy number 028 / Community support
NON-PROFIT or PUBLIC ORGANIZATION support
The request must be submitted prior to holding the event
Allow at least 15 working days prior to a council session (view the schedule at ville.saint-lazare.qc.ca/en/seances)
 
 1  Instructions

 

The form must be filled and submitted:
In person at   By email
 Centre communautaire
 1301, rue du Bois
 Saint-Lazare (QC) J7T 3E6
 450 424-8000 ext. 216
  vhuot@ville.saint-lazare.qc.ca

 

The form may be directly filled:
Online
ville.saint-lazare.qc.ca/en/soutien



 
 2
Information on the organization and the organizer:
 
  A Non-profit organization:   Public  
  A Sports / outdoor
Arts, culture
Recreation
Health, wellness
Education
Environment
Other
  Hospital centre
School board
Health establishment, Social services
School establishment
Ministry
MRC
Municipality
Office
Board
Other
 
  B The organization   C The organizer  
   
The organization's legal name




   
Last name
First name

Cellular
 
  Head office address  
The corresponding address is the same:
 
 

Civic No

Street



Apartment

Postal box



Postal code



Town



Province



Phone and ext.



Website



Email



Québec Enterprise Number (NEQ)



Does the organization have legal insurance?

No    Yes (specify)
                          Liability
                          Property
                          Administrators/management
  Yes No (specify)

Civic No

Street



Apartment

Postal box



Postal code



Town



Province



Phone and ext.



Website



Email



I agree to supply, upon request, any relevant document concerning the organization including financial statements:

Yes    No (explain why)

 
 
 3  Event / project / activity description:
 
  A
Describe your target audience:
  B
Describe the anticipated attendance :
 
  Kids (0 to 5 yo)
Kids (6 to 12 yo)
Youngsters (12 to 17 yo)
Adults (18 to 59 yo)
Seniors (60 yo and +)
Families
Not applicable
Less than 100 people
More than 100 less than 500 people
More than 500 less than 2000 people
More than 2000 people
Not applicable
 
 
  C
Is your event reccuring?
 
 
    Yes   If so, please indicate the year or years your event took place in Saint-Lazare  
No
Uncertain for now
 
 
  D Describe your event / activity / project  
 
   
Describe its mission, objectives, target audiences, attendance expected, your equipment, vehicles, your personnel (number of people)
or any other pertinent information to support your request.
The Town does not intervene on private property.
350 word maximum (You can also attach a document to this form below)
 
 
  E Event / activity / project dates and schedule  
 
   
Dates

Start (time)

End (time)

 
   
Dates

Start (time)

End (time)

 
   
Dates

Start (time)

End (time)

 
 
 4  Description of anticipated support
 
 
A
Financial
 
No

Yes (specify the amount)    $  

For what use?


B
Infrastructures
 
Indoor premises



Sport fields, parks



Electricity (Volts, Amps, # outlets)



Outdoor lights



Bathroom (access)



Access to water



Access for reduced mobility





C
Material resources
 
Tables


Tents


Reflective vests


Sound system


Chairs


Other


Other
 
D
Travaux
 
Road surface marking


Surface line markings


Street cleaning


Delivery


Pickup


Installation


Other


E
Communication
 
Postings (signs)


Communicate using the town's various communciation tools


F
Human resources
 
Blue collar workers


Other


G
Security
 
Firefighters


First responders


Flagman /traffic


Atendant-supervisor


Road closure


H
Parking
 
Parking spaces


I
Other
 
 


 


Attach a document or a picture of your project:




Enter this code