Small Community Grant Application Form · Web viewSmall Community Grants Application Form Closing...
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Small Community Grants Application Form Closing date 14th August Applicant Details Applicant name Organisation or group Contact Name of organisation Property Address Postal Address State Postcode Phone number Mobile number Fax number Email address Type of Activity: Activities that are eligible for funding include: ☐ Workshop, Field Days, Awareness raising events ☐ Aboriginal Culture and Heritage ☐ Mentoring, Leadership, Training, conference, small on ground community projects Eligibility: Which of the following best describes you, the applicant(s)? ☐ Landcare, friends of group or community environment group ☐ Group of landholders ☐ Farmer / producer group ☐ Aboriginal community organisation ☐ Other Do you have an Australian Business Number (ABN) ☐Yes ☐ No ABN: If your organisation is incorporated please provide number? Are you GST registered? ☐Yes If you, the applicant, are a previous recipient of grants from CMA and / or NT LLS have all previous grants been fully acquitted? ☐Yes ☐ No
Transcript of Small Community Grant Application Form · Web viewSmall Community Grants Application Form Closing...
Small Community Grants Application Form Closing date 14th August
Applicant Details
Applicant name
Organisation or group
Contact
Name of organisation
Property Address
Postal AddressState Postcode
Phone number Mobile number
Fax number Email address
Type of Activity: Activities that are eligible for funding include:☐ Workshop, Field Days, Awareness raising events ☐ Aboriginal Culture and Heritage ☐ Mentoring, Leadership, Training, conference, small on ground community projects
Eligibility: Which of the following best describes you, the applicant(s)?
☐ Landcare, friends of group or community environment group ☐ Group of landholders☐ Farmer / producer group ☐ Aboriginal community organisation☐ Other Do you have an Australian Business Number (ABN) ☐Yes ☐ No ABN: If your organisation is incorporated please provide number?
Are you GST registered? ☐Yes
If you, the applicant, are a previous recipient of grants fromCMA and / or NT LLS have all previous grants been fully acquitted? ☐Yes ☐ NoHave funds been sought for this project form any other sourcesor has this project been funded before? ☐Yes ☐ NoIf so, from whom?
Internal Use Only Date Received:
IRIS No: Receipt Officer:
See the Small Community Grants Application Guidelines supporting document on how to complete the following sections
1. Project title
2. Project Description
3. Project Objectives
4. Background and justifications
5. Anticipated project results?
6. Implementing and managing the project
7. Target Audience
8. Schedule Milestone Target Date
9. Budget – use template below or attach Excel spreadsheet using same format
Activity Details Proponent contribution
Other Contribution
Funding sought from NT LLS
TOTAL
Percentage %
10.Monitoring and Evaluation
11.Use of Best Available Information and Evidence
Declaration
Please check your application is complete, read and complete the declaration, then forward this application and any attached supporting documents to your local office or email to [email protected]
The information provided in this application is complete, true and accurate to the best of my knowledge. I have consulted with, and have the support of the Organisation and other organisations listed as contributors to this project.
Signature of Proponent
Name of Organisation
Date
Site Photos
Only For on ground change projects
Please provide ‘before’ photos of your project site to support your application.
Click on the boxes below to insert a photo from your computer. If digital photos are unavailable please contact NT LLS for alternate methods.
Photo 1 Photo 2
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