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.
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