Habitat Stewardship Program: expression of interest 2018 to 2019

Species at Risk stream                        

Project title:

_______________________________________________________

Project location:

_______________________________________________________

Applicant information

(This is the organization or identity that would sign a Contribution Agreement with Environment and Climate Change Canada [ECCC]; the information must correspond to the name and address to be used on any cheques if the application is approved and must be a legal entity or individual.)

Name of applicant:

_______________________________________________________

Organization:

_______________________________________________________

Address:

_______________________________________________________

Phone number:

_______________________________________________________

Secondary phone number:

_______________________________________________________

Fax number:

_______________________________________________________

Email address:

_______________________________________________________

Other communities/organizations involved in the Project (if partnering). Include both funding contributers and key stakeholders in the Project:


_______________________________________________________

Regional tiered terrestrial priorities addressed (Species at Risk stream)^{Footnote 1}

Does your project occur in a Tier 1 focal landscape?  □ Yes □ No

List which focal landscape:

_______________________________________________________

Does your project address a Tier 2 priority species?  □ Yes □ No

List which species:

_______________________________________________________

Does your project address a Tier 2 priority sector and/or key threat?  □ Yes □ No

List which priority sector and/or key threat:

_______________________________________________________

Does your project address a Tier 3 regional priority?  □ Yes □ No

List relevant regional priority areas, species and/or threats (for species, indicate the associated Species at Risk Act (SARA) Schedule 1 status):

______________________________________________________

Regional aquatic priorities addressed (Species at Risk stream)

Does your project address a regional aquatic priority?  □ Yes □ No

List which regional priority area, species and/or threat (for species, indicate the associated Species at Risk Act (SARA) Schedule 1 status):

_______________________________________________________

Proposed activities: Briefly describe the project—goals, objectives, activities, methods, budget estimates, partnerships and time frame.

_______________________________________________________

Permitting: It is your responsibility to acquire the necessary permits for the proposed project.
Have you considered the permits that need to be acquired prior to initiation of project activities? 
□ Yes □ No

Email completed form to the HSP Regional Coordinator by February 23, 2018. Early submissions are strongly encouraged.