2015-2016 BAND AID PROGRAM APPLICATION

INFORMATION & CHECKLIST

MusiCounts is committed to promote sustainable development in the communities
within which it works and beyond. To be consistent with principles of
promoting sustainability, MusiCounts urges Band Aid Grant applicants to submit
electronically allowing us to minimize and effectively manage waste generated from our
operations.
CHECKLIST
Your Completed Application should include the following:

Completed Official Application Form

Supplemental Information
Completed Musical Instrument Inventory Form and Wish List
Support Letters, from:

Principal

School Board

Parents

Community

Students

SUBMITTING YOUR APPLICATION

All completed Applications, including Official Application Form, Instrument Inventory Form,
supplemental information, support letters and documents should be submitted online.
Should you wish to apply using traditional methods (e.g. physical forms sent via mail), please
contact Noreen Malazo at the information below:
For any questions, please contact:
Noreen Malazo
Programs and Online Community Engagement, MusiCounts
345 Adelaide Street West, 2nd Floor
Toronto, ON M5V 1R5
TEL: 416.485.3135 ext 289
FAX: 416.485.4978
noreen@musicounts.ca

345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

BAND AID PROGRAM APPLICATION 2015-2016

NB: The funding from this program is awarded to Public (Elementary, Secondary &
Separate) schools in Canada, ONLY.
Please print clearly.
PART 1:
NAME OF SCHOOL: __________________________________________________________
SCHOOL ADDRESS:
Street __________________________________________________________________________
City / Town _______________________________

Province_____________________________

Postal Code ______________________________

Phone # _____________________________

E- mail __________________________________
School web site URL ______________________________________________________________

MUSIC TEACHER:

PRINCIPAL:

Name _________________________________

Name______________________________

Phone #________________________________

Phone # ____________________________

E-mail __________________________________

E-mail______________________________

GENERAL INFORMATION ON YOUR SCHOOL:

Name of School Board (if applicable) _______________________________________________
Business Number/ Charitable Number of the School or School Board ______________________
What classification is your school (e.g. Elementary, Jr. High, etc) _________________________
Grade levels ___________ to ___________
Total number of students in the school ________________

Socio-Economic breakdown of student population:

____________________________________________________________________________
/2

SPECIFIC INFORMATION
ON YOUR MUSIC PROGRAM:
345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

Please specify which program you are applying for (e.g. Grade 9-10 guitar program, school
band program). Be specific!
____________________________________________________________________________
Please specify if your music program is a:
New Program

Existing Program

Expansion of an existing program

PLEASE ANSWER THESE QUESTIONS ON YOUR OVERALL MUSIC PROGRAM IN THE

SCHOOL (All programs combined)
Number of music teachers and their status (full time, part time)
________________________________________________________________________________
Number of students in the Music Program ____________
Grade levels ________________

Ages__________________

Number of years the program has existed__________________

Number of music classes per week ______________________

Music programs offered in your school, include:

Marching Band
____________________ # of Players
Concert Band
____________________ # of Players
Jazz Band
____________________ # of Players
Orchestra
____________________ # of Players
Orff
____________________ # of Students
Steel Pan Band
____________________ # of Players
Other Music Programs (eg History, Theory, Appreciation)

How did you hear about MusiCounts Band Aid Program?

________________________________________________________________________________

Have you ever applied to MusiCounts before? If yes, were you approved? Please state the year and
the amount of the funding.
________________________________________________________________________________

Are you looking for $5,000 or $10,000 supply of instruments?

_______________________________________________________________________________
345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

Have you ever received any type of funding? If YES, please include details of amount and type.
________________________________________________________________________________

PART 2: (please complete & include with your Application)

Musical Instrument Inventory Form

Musical Instrument Wish List

345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

2015-16: MUSICAL INSTRUMENT INVENTORY

Please photocopy if you require additional sheets.
NAME OF SCHOOL:_____________________________________________________
Information provided by: ____________________________________________________

List of Instrument(s)
currently in your
schools inventory

Quantity

Current state of each instrument in

your inventory, as well as any other
relevant details

345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

Age of each
instrument in
your
inventory

2015-16: MUSICAL INSTRUMENT WISH LIST AND BUDGET PROJECTION

Please photocopy if you require additional sheets.
NAME OF SCHOOL:____________________________________________________
Information provided by: ____________________________________________________

List of Instruments your program would

purchase if awarded a grant

Quantity

Price

GRAND TOTAL:
345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

Total

PART 3:

Using a separate document please describe the compelling need for this supply of
instruments. This is a crucial section in this application. This is your opportunity to
address the Committee so please be sure to answer each and every question below.
Please try and limit you compelling needs document to three (3) pages.
1.
2.
3.
4.
5.

Why you need this supply of instruments and how you would use it;
How this supply of instruments would affect your current and future programs;
Qualifications of music teacher(s) and the level of his/her dedication to the program;
Evidence/history of a fundraising program for the music program;
Any additional information (First Nation students, special needs, breakfast programs,
other awards, etc.).
6. What makes your program unique? Please tell us of any individual stories that make this
program stand out

PART 4:
Supporting documents are important. These letters show us that there is support for this
program in the community. We are looking for quality NOT quantity. Please try and include
letters with personal stories rather than generic templates. Please try and include support letters
from the Principal, School Board and Parents. You may also provide additional letters from
representatives of the community, students, etc. Please include any relevant pictures in the
documents and any videos as web links.

Name of person submitting the application___________________________________________

Designation_________________________

E-mail __________________________________

# of years at the school______________

Contact # ________________________________

345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca

345 Adelaide Street West, 2nd floor Toronto, ON, M5V 1R5
Tel: 416.485.3135 | Fax: 416.485.4978
www.musicounts.ca / www.musicompte.ca