Fondation du maire de Montréal
Transcription
Fondation du maire de Montréal
Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates THE PROJECT SUBMISSION DEADLINE IS MONDAY, March 7, 2011 4.00PM Information on the candidate Candidate’s Address Full Name Address City Montréal, Québec Borough Postal Code Email Telephone Cell Mother Tongue English French Other If other, please specify: Education University (Specify your degree) Undergraduate Graduate Post Graduate In what discipline? College In what discipline? High School Other: please specify Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 1 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Demographics Birth Date: Sex: M F Canadian Citizen Permanent Resident Are you a member of a cultural community? Do you have dependent children? Yes Yes No No If so, please specify: If so, how many? Current Professional Status Full-Time Employee Part-Time Employee Part-Time Student Please note that full-time students are not eligible If other status, please specify: Income over the last year: $ Specify what year: Have you ever filed for bankruptcy? Yes No If so, in what year? If you have filed for bankruptcy, please include a copy of your Discharge Certificate with your Grant Application Form Are you subject to a voluntary deposit scheme? Yes Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca No 2 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Personal Financial Statement Candidate Last Name: First Name: Assets Value Assets Amount Transferred to the Business Cash (in hand) Balance of Checking and Savings Accounts Certificates of Deposit, Shares, Obligations, Mutual Funds, etc. Pension Plan (R.R.S.P., etc.) Computer Equipment (resale value) Movable Property (resale value) Real Estate (house, land, etc.) (resale value) Automobile (resale value) Other, specify: TOTAL: Liabilities Value Liabilities Credit Card Balance Line of Credit Balance Bank Loan Student Loan Car Loan Mortgage (land, house, etc.) Other, specify: TOTAL: Net Value TOTAL (Difference between the assets and the liabilities): Statement I certify that the information on this personal financial statement is accurate Signature: Date: Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 3 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Business Description Business Address Projected Start-Up Date: Name of Business: Business Address Current Projected Street Address: City: Montréal, Québec Postal Code:: Telephone: Cell: Fax: Email: Website: Name of Main Contact in Regards to this Application Last Name: First Name: Business Sector Food Services Education, Sports and Leisure Multimedia, Computer Sciences and Electronics Health and Wellness Communications and Marketing Literature Audio and Video Productions Interior Decoration and Planning, Furniture Fashion Specialized Products and Services Transportation Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 4 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Business Description (continued) Business Activity Distribution Retail Sales Production / Manufacturing Personal Services Corporate Services Business Legal Structure Company General Partnership Sole Proprietorship Limited Partnership Business Number: Cooperative Effective Date: Project Description and Business Mission Grant Requested: $ For a maximum of 25% of the start-up costs as determined on page 9, up to a maximum of $7 500 Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 5 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Financial Structure Financial Projections and Economic Impact Estimated Revenues Year 1 $ Estimated Profits $ Year 2 $ $ Estimated Full-Time Jobs Created Estimated Part-Time Jobs Created Estimated Contractual Jobs Created Note: Include the candidates in the number of estimated jobs Projected Start-Up Costs Note: Please include a detailed list of your start-up costs(in hand and required) for any category of costs that is higher than $2 000 Fixed Assets In Hand + Required = Total Leasehold Improvements Computer Equipment Software Production Equipment (machinery, etc.) Other Equipment (tools, etc.) Rolling Stock Office Equipment (fax, photocopier, etc.) Office Furniture Licenses, Permits, Patents Other, specify: Sub-Total A Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 6 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Financial Structure (continued) Projected Start-Up Costs (continued) Note: Please include a detailed list of your start-up costs(in hand and required) for any category of costs that is higher than $2 000 Start-Up Costs In Hand + Required = Total Installation Charges (telephone, electricity, Internet, etc.) Security Deposits (public utilities, lessor, etc.) Legal Fees (registration, incorporation) Professional Fees (accountant, notary, etc.) Office Supplies (stationery, stamps, etc.) Promotional Print Material and Tools (corporate documents, business cards, catalogs, etc) Multimedia Promotional Tools (web site, DVD etc.) Other, specify: Sub-Total B Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 7 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Financial Structure (continued) Projected Monthly Operational Costs (maximum 3 months) Amounts to take into account to meet the needs related to your expenses over the first 3 months of operation ($) Costs X 3 Months = Total Sub-Contracting Rent Electricity and Heating Insurance (office, automobile) Taxes and Permits (business taxes) Maintenance and Repairs Equipment Rentals Telecommunications Expenses Sales and Travel Expenses Initial Advertising and Promotional Expenses Office and Computer Supplies Professional Fees Other, specify Sub-Total C Inventory ($) Costs X 3 Months = Total Raw Materials, specify: Finished goods, specify: Sub-Total D Total Projected Start-Up Costs (A+B+C+D) Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 8 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Financial Structure (continued) Total Projected Financing Personal Contribution ($) Amount Investment by the Candidates in Cash Investment by the Candidates in Equipment Sub-Total E External Financing Confirmed Not Confirmed ($) Amount Donations by Private Investors (family/friends) Loans by Private Investors Fondation du maire Grant (maximum of 25% of start-up costs) Jeunes promoteurs Grant Credit Line Bank Loan Small Business Loans (SBL) Fonds Local d'investissement (FLI) Other, specify: Sub-Total F Total Projected Financing Sources (must be equal to total projected start-up costs) ( E + F ) Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 9 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Financial Structure (continued) Statement by the Business’ Designated Representative I certify that all the information provided in this form is true and accurate and I consent to it being divulged. I also agree to provide, upon request by the Fondation du maire, any document that is pertinent to the present application for financial assistance. I also agree to provide the Fondation du maire with my credit profile, which I will have obtained from a credit bureau. Any inaccurate information, false declaration or significant omission will automatically result in the final rejection of the grant application or the reimbursement of the grant that was awarded. Read and approved, in Montréal, on: (date) Signature: Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 10 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Check List – Grant Application Have you submitted the required documents? 5 copies of each of the following documents are required Properly filled in Grant Application Form Business plan including at least all the items listed in Appendix I “Model Business Plan” Curriculum vitæ of the key individuals involved in the project Any other document that you deem pertinent (contracts, letters of intent, catalogs, prototypes, portfolio, letters of recommendation, letters of support, letters confirming the project’s financing sources, etc.) Credit File – See Appendix II 1 copy of each of the following documents is required for each of the eligible candidates Proof of age (health insurance card, birth certificate or driver’s license) Proof of Canadian citizenship or permanent residency status (citizenship card, passport, birth certificate or permanent resident card) Proof that you have lived on the territory of the urban community of Montréal for at least three months, such as a lease or two invoices (Hydro-Québec, Bell Canada, Vidéotron or GazMétro) – a recent one and another dated three months back Proof of income (summary of the notice of assessment regarding your most recent income tax return form, provided by the Ministère du revenu du Québec or the Canada Customs and Revenue Agency) Proof that your company is incorporated or registered, as the case may be Proof of your company’s address or upcoming address If you are including other supporting documentation, please specify Catalog Portfolio Prototype DVD Sample Other, specify: Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 11 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates How did you hear about Fondation du maire? Word of Mouth Emploi Québec (Jeunes volontaires) Youth Employment Services City of Montréal Other Fondation du maire grantees SAJE, specify: CDEC or CLD, specify: CJE, specify: On the web, specify: Info Entreprises Communication Québec Media, specify: Other, specify: Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 12 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Appendix I Model Business Plan The following must be included with your application Executive Summary (1 page) Table of Contents 1. Project 1.1. Business Mission 1.2. Product(s)/Service(s) 1.3. Objectives 1.4. Scheduled Achievements 1.5. Legal Structure and Ownership 2. Candidates 2.1. Experience of Candidate(s) 2.2. Delegation of Responsibilities / Tasks 2.3. External Resources 3. Market Analysis 3.1. Global Market Assessment 3.2. Targeted Market 3.3. Assessment of the Competition 4. Marketing 4.1. Product(s)/Service(s) 4.2. Pricing 4.3. Promotion 4.4. Distribution 5. Operations 5.1. Location 5.2. Production 5.3. Supplies 5.4. Human Resources 6. Risk Management 6.1. Identification of Risks 6.2. Measures to Undertake / Scenarios 7. Financial Forecasts 7.1. Detailed List of Start-Up Costs 7.2. Forecasted Financial Statements for 2 years (income statements, forecasted balance sheets and your monthly cash budget for a period of 24 months) 7.3. Breakeven Analysis Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 13 Entrepreneurship Business Plan Contest Grant Application Form If more than one person is in charge of the project, this form must be filled in by all the candidates Appendix II Credit Profile You can obtain your credit profile from the following organizations: Credit Bureaux Note: You will be required to provide two documents to support your identity when you make your request, including at least one with a proof of your address. Trans Union Canada (free) Consumer Relations Division 1, Place Laval, Suite 370 Laval (Québec) H7N 1A1 Tel.: 1 877-713-3393 or 514 335-0374 Website: www.tuc.ca Equifax Canada Inc (for a fee) Consumer Relations Services Po Box: 190, Station Jean-Talon Montréal (Québec) H1S 2Z2 Tel.: 514 493-2314 or 1 800-465-7166 Website: www.equifax.ca Fondation du maire de Montréal pour la jeunesse 425, place Jacques-Cartier, Suite 10, Montréal, Québec H2Y 3B1 514 872-8401 www.fondationdumaire.ca 14