Kwänlin
Whitehorse
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Takhini River
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Dä̀kwä̀kä̀da
Haines Junction
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Shadęl
Champagne
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Tthe yänlin
Canyon
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Lu ghä
Klukshu
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Forms
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Application Form Entrepreneur Equity Fund (“EEF”)
Application Form Entrepreneur Equity Fund (“EEF”)
Date
MM slash DD slash YYYY
Part 1 - Applicant Information
Applicant Name
First
Last
Mailing Address
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Residential Address
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Phone number
Alternate phone number
Email
PART 2 – Business Information
Business name
Mailing Address
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Phone number
Alternate phone number
Email
Website/Facebook/Instagram
CRA/Business Number
Is your organization incorporated and in good standing?
Yes
No
How long has your business been in operation or when do you plan to start operations?
Does your business/do you do any of the following (if yes please state how)?
enhance employment opportunities for Citizens in the Traditional Territory and throughout the Yukon;
provide a supportive business/employment for Citizens;
support businesses to hire Citizens;
help Citizens build personal wealth and increase self-reliance, thereby contributing to CAFN’s vision of a self-reliance;
cultivate a culture of employment amongst Citizens; and
promote economic development consistent with the Final Agreement (Chapter 22)
Select All
Please explain how your business supports any of the above choices.
Principal Owners - If you, the Applicant, are applying for an existing business - list the principal owners of the business and any other owners:
Business Structure - Describe your businesses mandate, governance structure, primary business activity or service.
Location of business:
Business description - In 1000 words or less, please describe your business in simple terms. What do you intend to do? How you intend to do it? Who will be involved in the business?
(Required)
What jobs might be created (if any) for CAFN Citizens and where would those jobs be located? *Refers to employment that does not exist prior to the project, but that would be created if the project is funded by under EEF.
PART 3 – Eligibility – do you/your business qualify for EEF program funding?
Applicant Eligibility - Check all that apply
a Citizen for at least 12 months
enrolled under the Äghàałān (My Relatives) Enrollment Act
a Canadian resident
How much funding are you applying for in total in this Application?
Less than $5,000
$5,000 - $10,000
What is the nature of the equity you are providing?
EEM – you must provide a 50% contribution
Business Studies – you must provide a 25% contribution?
If you are applying for EEM, what are you proposing to spend your EEM contribution on?
Contractors, payment of honoraria to elders and other experts
Overhead, including, but not limited to, rent, utilities, supplies, minor repairs and maintenance, accounting and audit services, and insurance;
Minor machinery and equipment including dogs/dogsleds/horses, and related equipment (i.e. equine therapy);
Communications, including, but not limited to, development of content, translation, dissemination, advertising, and signage;
Professional, consulting, advisory and other services, including fees, travel, and report production;
Attendance at or participation in training and professional development programs, conferences, workshops, seminars, events, and meetings, including but not limited to tuition, registration, travel, testing and evaluation;
Work experience including travel;
Vehicles - recipients can only use EEM funding to pay for vehicles that are used primarily for business purposes (i.e. more than 50% of the time), essential for their business, identified clearly for the purpose of the business (i.e. stickers on vehicle), and are insured as commercial/business vehicles (up to a maximum of $5,000.00);
Preparation, organization and delivery of conferences, workshops, seminars, events, meetings and information sessions, including, but not limited to, room and equipment rentals, food and beverage, promotion, presenters' or facilitators' costs, and travel;
Preparation, organization and delivery of training and professional development, including, but not limited to, curriculum and materials, rentals and travel;
Land surveys and appraisals
Awareness and information sessions, training, and communications relating to environmental promotion and compliance;
Feasibility studies, marketing, advertising, and promotion;
Materials and tools to support small business people/artists for arts and crafts (but not hobbies) including, but not limited to, beads, fur, material, sewing supplies, paint, silver for jewelry, instruments, etc.; and
Land/property acquisition costs are eligible when the acquisition of land/property is an essential part of the business.
**You must spend your EEM contribution on an eligible expenditure. The following are NOT eligible expenditures for the Policy: • Salary, pension and benefits. No • Passive investments. No • Capitalization costs including the establishment or expansion of financial instruments (shares or a portion of an asset which will be capitalized over time). No • Bad debt expenses and expenses associated with collections. No • Costs for services provided by a federal or provincial/territorial or First Nations government. No
If you are applying for funding for a Business Study, please provide details about your plans.
feasibility or business planning
market studies;
research or assessment;
technical research;
product design or engineering; or
architectural studies.
Please describe here.
Are you in good standing with CAFN?
Yes
No
(do you owe any money to CAFN and if so, are you in a repayment plan with CAFN and have you made payments to CAFN according to your payment plan for a period of at least 6 months?)
Part 4 - Risk
List any identified risks associated with specific business activities; these may include risks to the work plan, budget, staffing, shipping, and identify the mitigation strategies you will use to minimize the impact of these risks in order to ensure the successful completion of your project.
List any identified risks associated with specific business activities:
PART 5 – Supporting Material Checklist
I have attached all of the following MANDATORY documents with my application (check as completed):
Completed detailed Budget, listing all sources of funds for this project and all planned expenditures
Confirmation of Financial Contributions and/or Letters of Support from project partners confirming financial/ in-kind contributions and general support for the project, as applicable
Business or Strategic Plan (Any strategic plan, business plan or other documents that show how the project relates to the organization’s overall vision and mandate should be submitted)
Other relevant documents (This could include previously completed feasibility studies, community plans or consultation documents, third-party market analysis, or other documents that demonstrate economic opportunity). Please list as applicable
Are there any supporting documents you would like to attach?
Max. file size: 64 MB.
File
Max. file size: 64 MB.
File
Max. file size: 64 MB.
PART 6 - Other Considerations
Declaration – Amounts Owing Declare any amount currently owing in default to CAFN or any other government
PART 7 - Authorization
Consent
(Required)
I agree to the privacy policy
The information collected in your application will be used, and may be disclosed, for the purposes of assessing the merits of your application. As part of the assessment process, the information may be shared with external consultants, review committee members, officials in other departments, CAFN officials and/or members of CAFN’s First Nations Council.
It may also be used and/or disclosed for policy analysis, research, and/or evaluation purposes. In order to conduct these activities, various sources of information under the custody and control of CAFN may be linked.
In the event that the application contains personal information, the personal information will be administered in accordance with the Privacy Act (Yukon) and/or any relevant CAFN legislation, regulations, policies or procedures. The application is also subject to the Access to Information Act (“ATIA”). The ATIA provides every person with a right of access to information under the control of the department, subject to a limited set of exemptions.
Applicant Signature:
Date
MM slash DD slash YYYY
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