Community Sport Grant Community Grant Application Form

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1 Community Sport Grant Community Grant Application Form Application Form 2017/18 Opens 26 March 2018 Applications close 12.00pm 27 April 2018 for projects/events from 1 July June 2018 Late applications will not be considered. Please note that your application (including any personal information supplied) will be made available to the committee and the public. To discuss your project or for assistance with your application please contact - Name: Vivien Andrews Name: Christine Turton (Secretary, LTDSAC) Phone: Phone: Or contact Rose Prisk, Taupo District Council Please write clearly using a black or blue pen and send your application to: Post to: Deliver to: to: Lake Taupo District Sports Advisory Taupo Sport House admin@tauposac.org.nz Council Inc., 39 AC Baths Ave PO Box 13 Taupo Taupo Check your eligibility Before you fill in this form, read the guide for applicants carefully to make sure you are eligible to apply, and find out about the types of activities that may be funded. This can be found on the Taupō District Council website

2 1. Application details Name of individual Or Group/organisation: Are you applying as an Individual Individual Group/organisation or as a group (Tick those that apply) Registered Charity Incorporated Society and Number or Trust DOB (if applicable) Physical Address: Mailing Address if Different: Telephone number(s): 2. Application summary Grant purpose or Event name: Date the funds are Required: Total cost of this Project: Amount Requested:

3 3. Details of funding required Please provide more details of the funding required: 3.1 Briefly describe Your project/activity that you are seeking funding for (up to 300 words) 3.2 How many will benefit from your project/activity? 3.3 Is your project/activity an event? Yes No If you answered yes to question 3.3 answer the below questions. Event name: Event start date: 4. Who is involved in the project/activity? 5. How will this project/activity benefit the community and fit into Council s Long Term Plan Goals?

4 Long Term Plan Goals Ensure that the Taupō District remains a great place to live Promote economic development Protect our water resources and use them wisely Maintain the quality infrastructure that we have Keep rates and debt affordable 6. Financial information (all grants are GST inclusive) Bank account name: (please make sure this is the name of the account where the grant will be deposited) Is your organisation GST Registered? No Yes GST No. Have you provided two quotes in support of your application? No Yes If answered no above, please explain why. 7. Financial background Have you applied to other funders for this project/activity? Date applied example Source of funding Type of funding (e.g., a loan, grant and what it will be used for) Amount requested Is funding confirmed? If yes state how much. If you are still waiting for response, when will you know the result? 01/02/2016 Charitable Trust Sponsorship $10, Yes, $5, A. Total cost of this project $ B. Less total funds available $ C. In kind contribution $ D. Difference $ E. Amount requested $

5 8. Groups and organisations only 8.1 What are your main sources of funding that your organisation receives e.g. contracts, subscriptions, and grants? 8.2 Please state the reason why the above funds area not being used to support this project/activity 9. Planning Please provide a time frame for your project/activity: (attach timeline if relevant) Please provide a budget for your project/activity: (attach cost break down/spreadsheet for the whole project/activity if relevant) 10. Would you like to present your application to the funding committee in person? Yes No Name of presenter: I declare that the information supplied here is correct. If the application is successful, I/we agree to/that complete the project/activity and use the allocated funds within a year of the funding being approved complete and return the accountability form (which will be sent with the grant) within three months of the project/activity being completed any unused grants or portion of a grant will be returned to the distributors participate in any funding audit of my organisation or project conducted by Council if required inform Taupō District Council Rose Prisk; rprisk@taupo.govt.nz, of any public event or presentation that is funded by the TDC community grants acknowledge the assistance of the TDC community grants verbally at event openings, presentations, performances and such like use the Taupō District Council logo Rose Prisk; rprisk@taupo.govt.nz, and distribution agency logo in publicity for the project and follow the guidelines for use of the logo.

6 Group/Organisation Application Authorised Signatory 1: Name Designation Personal Street Address: Telephone number(s) Authorised Signatory 2: Name Designation Personal Street Address: Telephone number(s) Individual Application Name: Signature: Signature of parent or guardian if applicant is under 16 years or age: Position in organisation (if applicable): Date:

7 Final Check Make sure you have Completed all sections of application Checked that the budget balances Provided 2 quotes or reason why if not able to do so Pre-printed Bank deposit slip Latest audited accounts or current statement of income and expenditure for past 12 months and a copy of your latest bank statement Other relevant supporting information (proof of affiliation to a national body, registered charities commission certificate, certificate of incorporation, supporting letters and evidence of selection/registration) Has the application been signed? Have you kept a copy for your records? Have you completed and submitted an Accountability form from previous successful funding rounds?

8 Community Funding Criteria Financial grants to individuals are in recognition of national and international excellence in sport and the profile their selection will bring to the community Individuals applying for assistance shall have documentary evidence of the event they are attending, the nature of their selection, the national/regional body they represent and residency in the Taupo District (university and school attendance outside of the district does not meet the criteria) Grants may not be used for the following Capital improvements to facilities not owned by the applicant Maintenance of equipment or facilities, including day to day vehicle running costs Wages/salaries on an ongoing basis Food/catering for an event Insurance Subscriptions Services or projects seeking to promote commercial, political or religious objectives Costs associated with fundraising events where profits are redistributed to another group Debt servicing or repayment Legal expenses Medical expenses Public services that are the responsibility of central government (e.g. core education, primary health care) eg. School sports teams/individuals Purchase of alcohol Social sports teams/groups THE FUNDING COMMITTEE S DECISION IS FINAL AND NO CORRESPONDENCE WILL BE ENTERED INTO FOLLOWING NOTIFICATION

9 Guide to the Community Grant Application Form (Individual) 1. Application details Name of individual please include date of birth 2. Application summary Date the funds are required pleased state whether funding is sought is a reimbursement or future funds Amount requested must be a minimum of 50% of the total cost 3. Details of funding required If applying for event/tournament costs, you must provide evidence of selection/qualification 8. Final check make sure you have In the case of reimbursement funding, submitted all relevant receipts Guide to the Community Grant Application Form (Clubs) 2. Application summary Date the funds are required pleased state whether funding is sought is a reimbursement or future funds Amount requested must be a minimum of 50% of the total cost 8. Final check make sure you have In the case of reimbursement funding, submitted all relevant receipts

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