2006-07 Women’s Leadership & Development Programme

Capacity Building Grants

Application Form

Applications close COB Friday, 15 December 2006

Instructions

Please read the Women’s Leadership and Development Programme (WLDP) Capacity Building Grants Application Guidelines before completing this form. Eligible national and state/territory women’s non government organisations may apply for funding of up to $25,000 per project to develop initiatives that build their capacity, are relevant to current women’s issues and progress at least one of the Office for Women’s (OfW’s) policy goals. A total of $250,000 in funding is available. Applications must be prepared in English in accordance with the Application Guidelines and may be hand written in biro or prepared electronically by downloading a copy of the appropriate form from the OfW website: www.ofw.facsia.gov.au. Organisations applying as a consortium must nominate a lead agency to prepare the application on their behalf and provide the information requested on page 5. Please ensure that you complete all sections of this form, attach copies of the requested documentation where you see this symbol and arrange for the President, Chair or equivalent of your organisation to sign the declaration at the end of the form. Please note: Applications that are incomplete, do not address the selection criteria, do not include the requested documentation, have not been signed by the relevant authority or are submitted late (without the OfW’s permission) may be deemed ineligible.

Part 1 – Your Organisation 1. Contact Details (if applying as a consortium, enter the details of the lead agency. See the Application Guidelines for further information about organisations wishing to apply as a consortium) Organisation: President / Chair / Executive: Project Officer: (all correspondence will be sent to the Project Officer) Phone: (office) Fax:

(mobile) Email: Postal Address: Street Address:

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2. Business information Is your organisation:

Incorporated Please attach: copy of incorporation certificate. or

Other legal entity

Please attach: copy of articles of association, constitution or other supporting documentation.

Is your organisation registered for GST?

Yes No

Please attach: copy of Taxation Status Form.

What is your organisation’s ABN? 68081443503 Insurance To be eligible to apply for funding, your organisation must have: 1. Public liability insurance (minimum $10 million); 2. Professional indemnity insurance (minimum $5 million); and 3. Workers’ compensation insurance (as required by relevant state/territory laws).

Please attach: copies of certificates of insurance cover. Financial information

Please attach: copy of most recent Audited Financial Statement. 3. Organisation profile Please outline the role, function, aims and objectives of your organisation.

What initiatives and mechanisms does your organisation utilise to:

• promote the interests of its members; and • work toward increasing its membership base.

3. Funding information Current funding applications Please list all current funding applications your organisation has submitted or is preparing to submit to other funding bodies, including Australian, state/territory and local government agencies and private organisations. Date Funding body Programme Project description Funding

sought Funding period

Not applicable at time of preparing this application

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Funding history Please list all funding your organisation has received over the past 5 years from other funding bodies, including Australian, state/territory and local government agencies and private organisations. The panel is asked to note that the funding detailed below is listed ex GST Date Funding body Programme Project description Funding

received Funding period

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3. Consortium applications (if applicable) Organisations applying as a consortium must nominate a lead agency for the project to act on behalf of the consortium. The lead agency must prepare and authorise the application and a Statutory Declaration. Consortium members must also provide written authorisation for the lead agency to act on their behalf. Please list the member organisations of the consortium: 1

Not applicable

2

3

4

5

Please state the lead agency that will act on behalf of the consortium:

Please attach: • a Statutory Declaration from the lead agency indicating its responsibility to act

on behalf of the consortium; and • written authorisation from all consortium members (signed by the President,

Chair or equivalent of each organisation) for the lead agency to act on behalf of the consortium.

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Part 2 – The Project 1. Project title:

2. Funding requested (excluding GST): $

3. Project description:

Please provide a short statement describing your project, explaining how it would benefit women.

4. Project Budget

Please provide an itemised budget of all expenses associated with the project, including items funded through other sources and the cost of an independent auditor.

Item of expenditure (eg advertising, printing, staff costs) WLDP Grant

$ Other Sources

$

TOTAL

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4. Funding payment schedule Funding will usually be provided to grant recipients in the following three instalments: • Instalment 1: 40% of total grant funding

Paid upon signing of the Funding Agreement by the Australian Government (as represented by FaCSIA) and the grant recipient and submission of a satisfactory project milestone plan by the grant recipient.

• Instalment 2: 50% of total grant funding Paid upon submission of a satisfactory project progress report by the grant recipient to the OfW.

• Instalment 3: 10% of total grant funding Paid upon submission of a satisfactory final project report by the grant recipient to the OfW.

Request to change funding payment schedule If the project is likely to incur the majority of costs during the first 3 to 6 months, you may request a different breakdown of payments, subject to approval by the OfW. Please indicate the preferred instalments below and state reasons:

Instalment 1: $

Instalment 2:

$

Instalment 3:

$

Reason:

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Part 3 – Selection criteria Please provide a statement against each of the following selection criteria (maximum one page per criterion). Your responses to the selection criteria will form the basis of assessment. Criterion 1 The project outcomes:

(a) strengthen the capacity of your organisation;

(b) address an existing need; (c) are achievable; and

(d) are sustainable beyond the 12 month funding period. Project outcomes are things that are achieved for women or for women’s groups as a result of undertaking the project (eg the outcomes from a project that involves an organisation developing its own website might be that women have improved access to information about the organisation’s events and services). Issues to consider: • In what ways will the project outcomes strengthen the capacity of your organisation? • Is there any evidence / research / information available as to why this is an area of need? • Would the project duplicate other work that is underway? • Are the project outcomes realistic? • Is there support for the project outcomes outside of the organisation? • Can the project outcomes be applied to a wider audience? • Is there a plan for expansion and resources to make it possible?

Applicant’s response:

Criterion 2 The project demonstrates relevance to current women’s issues and at

least one of the OfW policy goals. Issues to consider: • What issues currently facing women in Australia would the project address and how? • Which OfW policy goals would the project address and how?

Applicant’s response:

Criterion 3 The application demonstrates consultation with key stakeholders in

developing the project proposal. Issues to consider: • Have you consulted widely with organisations that have an interest in your project (eg other NGOs,

local councils, government departments, researchers or other specialists in the field)? • Please include details of:

- organisations you have consulted with in preparing the application; - the level of support that has emerged from your consultations; and - organisations you expect to consult with during the project.

Applicant’s response:

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Criterion 4 The applicant demonstrates the ability to: (a) plan;

Please complete the Project Plan template over the page.

(b) manage; Please state who will manage your project and outline their project management experience.

(c) monitor; and Please outline how the project would be monitored to ensure it is progressing according to the Project Plan. Grant recipients are required to provide progress reports and a final report on the implementation and success of the project.

(d) evaluate the project. Please outline the evaluation methodology for your project and include details of: • who you intend to seek feedback from; • the type of information you will collect; • collection mechanisms to be used (eg. survey, interviews, etc); and • when data will be collected. Part of the evaluation will be based on responses to a WLDP Project Evaluation Questionaire, which must be completed by at least six project participants.

Applicant’s response:

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Project Plan Template Please outline the key deliverables for your project, associated milestones and dates for completion. Please base your timeframe on a project commencement date of 1 June 2007 and project completion date of 1 June 2008. Final dates will be subject to the timing of grant payments.

The panel is asked to note that as this project will be ongoing, a number of milestones occur outside the project timeframe.

Deliverable Milestone Dates / Timeframe

Example: Develop a report on the technical specifications for website

Establish working group Develop draft report Deliver final report for Executive approval

By 15 June 06 By 30 June 06 By 14 July 06

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Part 4 – Referees Please provide the contact details of two referees who can comment on your organisation’s ability to successfully complete the project and administer project funds - one from an agency that is familiar with your organisation’s work and one from an agency that has provided funding to your organisation, preferably in the last five years. If your organisation has not received funding in the past, please provide the names of two referees who are familiar with your work. 1. Referee who is familiar with your organisation’s work Name: Organisation: Position: Phone: (office) Fax: (02) 9387 5437

(mobile) Email: Postal Address: 2. Referee who has provided funding to your organisation Name: Organisation: Position: Phone: (office) Fax:

(mobile)

Email: Postal Address:

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Delegate authorisation (This Authorisation must be signed by the Chair or President of the organisation) I of ______________________________ State_____________________________ certify that the information given in this application is true and correct to the best of my knowledge. Signature: ______________________________ Date: _____________________ Name:

Organisation:

Position:

Phone: (office)

Fax:

(mobile)

Email:

Postal Address:

Please submit the original application form and four copies

by post or delivery to: Women’s Leadership & Development Programme Capacity Building Grants C/- Leadership Section Australian Government Office for Women Department of Families, Community Services and Indigenous Affairs

Post: PO Box 7788 Canberra Mail Centre ACT 2610 Delivery: Ground Floor Juliana House Bowes Street Phillip ACT Helpline: 1800 808 863

Applications must be received by the OfW by:

COB Friday, 15 December 2006

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Checklist Before submitting your application please ensure that: your organisation is eligible to apply (see the Application Guidelines). you have completed all sections of the application form. you have attached copies of all the requested documentation, including:

• your organisation’s incorporation certificate, articles of association, constitution or other legal documentation;

• your organisation’s Taxation Status Form • certificates of cover for public liability/professional indemnity and workers

compensation insurance; • your organisation’s latest audited financial statement or statement of income and

expenditure for the 2005-06 financial year; and • for consortium applications, a Statutory Declaration from the lead agency and

written authorisation from the member organisations for the lead agency to act on behalf of the consortium.

the President, Chair or equivalent of your organisation has signed the Declaration. you have submitted the original and four unbound copies of the application form. you have taken a copy of the completed application form for your records. Where did you hear about the Women’s Leadership and Development

Programme Capacity Building Grants? Australian Government Office for Women website.

National Secretariats email network.

Newspaper

Other (please specify):

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