Grant Application

GRANT FUND APPLICATION FORM

Grant opening date: 16th July 2018
Grant closing date: 31st August 2018
Contact for inquiries: Chrissy Jones
Phone: 0455 993 112
Email: admin@sdcf.org.au

SECTION A: ORGANISATIONAL DETAILS

Contact Details
Applicant / Organisation Name (required)
Email Address (required)
Postal Address
Street Address
City
State
Postcode
ABN
Contact Person Name
Position
Mobile Phone
Work Phone
Organisational Information
Provide a percentage breakdown of annual income between: Type Total
Governement %
Philanthropic %
Corporate %
Fundraising %
Service Fees %
Other %
Please indicate the region in which your service delivery is primarily focussed: NambourNambour and surrounds (within 20kms)Other
If Other:
Please indicate which area your organisation meets the eligibility criteria: A not-for-profit community organisationA registered charity with the Australian Tax Office (ATO)Endorsed by the ATO as a deductable Gift RecipientAn educational institution
Financial Details
This information must be from your most recent audited/reviewed financial statements
Item Amount ($)
Annual Income (Governement) $
Annual Income (Other) $
Annual Income (Total) $
Liabilities $
Annual Expenditure (Total) $
Surplus / Deficit $

SECTION B: PROJECT DETAILS

Project Title:
Total Budget for Project: $
Attach a detailed budget for the proposed project.
E.g. proposed cost for each strategy / component of the project
Amount ($) being requested (GST Exclusive): $
Project Start Date:
Project End Date:
State the principal aim of the proposed project:
Describe how the proposed project will meet the eligibility criteria e.g.:

  • A not-for-profit community organisation
  • A registered charity with the Australian Tax Office (ATO)
  • Endorsed by the ATO as Deductable Gift Recipient
  • An educational institution
Describe what outcomes are expected to be achieved:
Describe how the proposed project will be undertaken, including (or attaching) a detailed project plan, clear description of initiatives and expected timeline for completion of the project and include details of any external service providers:
Is there a potential for this project to be shared with other similar organisations/service providers and if so, how and with whom?:
If only part funding is required for the proposed project outline how the applicant will fund the whole proposed project:
If your application is successful the Foundation requests your agreement to acknowledge the funding from the Foundation in publications, social media, website, etc.: Yes I agreeNo I do not agree
If your application is successful the Foundation requests your agreement to be involved in publicity regarding the Foundation's grant program.
This may include provision of photographic material for use on social media, displaying promotional materials and participating in the Foundation's fundraising activities:
Yes I agreeNo I do not agree
Authorised Person Name:
Position in Organisation:
Authorised Person Acceptance (in lieu of signature):
Authorised Date:

* Required