FUNDRAISING APPLICATION FORM

Transcription

1 FUNDRAISING APPLICATION FORM TELL US ABOUT YOU First name Last name Organisation name (if applicable) Address Suburb State Postcode Daytime phone Mobile (this is our preferred contact method with you) SUPPORTING US Which fund will you support? Dementia Australia Research Foundation Hazel Hawke Alzheimer s Research and Care Fund TELL US ABOUT YOUR FUNDRAISER Name of your fundraising event Details of your event Date/s and time/s (if your fundraiser is long-term please estimate a start and end date) Venue and address (if an event) Estimated attendees (if an event)

2 How will funds be raised? Please be specific, for example: online donations, ticket sales, sale of merchandise, food sales, raffles, gold coin donations etc How much is your anticipated revenue $ How much are your estimated expenses $ According to the Fundraising Act 1998 expenses should not exceed 40% of your fundraising goal. TIP: Seek sponsorship & donated goods to keep expenses to a minimum. Have you investigated fundraising laws in your state? No Yes I require help Will you need to obtain any licences, permits or permissions? If yes, please describe. Will you be publicising your event? No Yes If yes - how will you promote your activity? Please be specific, for example: websites, posters, social media posts, news etc Do you have a reason for fundraising for Dementia Australia Research Foundation?

3 HOW CAN WE SUPPORT YOU? Due to limited resources Dementia Australia Research Foundation is not able to take on a coordinating role for your event but our fundraising team can provide you with advice and support as well as a number of useful resources where possible. Please let us know what would help you: Dementia Australia Research Foundation materials and resources (donation envelopes, pamphlets) Dementia Australia Research Foundation digital materials and resources (logos, signage, fact sheets, statistics etc.) Online fundraising and promotion (help with setting up an online fundraising page, social media pages and online content) Media Consent I give my consent to be contacted about photographs, stories and information about my fundraising event. I understand that Dementia Australia Research Foundation may wish to use details of my event to promote fundraising for Dementia Australia Research Foundation. I agree to Dementia Australia Research Foundation including the name of my fundraising event in the Community Fundraising pages of the Annual Report. My personal name will not be included unless permission is sought. TERMS AND CONDITIONS Fundraising for Dementia Australia Research Foundation Organisers must be registered and have an official Letter of Authority issued by Dementia Australia Research Foundation for their activity. This is required by law in most states of Australia, and is a requirement of fundraising for Dementia Australia Research Foundation. Organisers must be 18 years or older to register as a community fundraiser or have a parent or guardian submit the application on their behalf and commit to supervising them at the event or activity. The individual whose name appears on this form will be solely responsible for the coordination, conduct and outcomes of the activity or event in question and Dementia Australia Research Foundation bears no responsibility for the conduct or management of the fundraising event in question. Liability and insurance It is the organiser s responsibility to ensure their event or activity is compliant with all legislative requirements, and investigate and obtain any necessary permits, licenses, permissions and authorities needed in any state/territory or local council where the event is taking place. This includes holding the required insurances such as public liability insurance. The organiser must take responsibility for the safety and security of all participants in the fundraising event including themselves. By signing this form the organiser indemnifies Dementia Australia Research Foundation for all liability or costs that may arise in respect to any damage, loss or injury that occurs to any person in any way associated with the event or activity.

4 Branding and media The organiser will seek express written permission before using the Alzheimer s Australia or Dementia Australia Research Foundation brand in any way, such as printed materials or advertisements, including the use of: logos taglines, images and any other brand elements. Logos are not to be modified or used for any other purpose than those stated in the application form and confirmed in an authorisation letter. Any approved branding should only be used within the agreed period that your fundraising activities are taking place and any use outside those dates will require further authorisation. The event or activity should not be named or branded as Dementia Australia Research Foundation (for example: Dementia Australia Research Foundation run or Dementia Australia Research Foundation gala ). The organiser should seek to instead name the activity themselves with support being promoted with the text supporting Dementia Australia Research Foundation or raising funds for dementia research. All media materials and press releases must be approved by Dementia Australia Research Foundation prior to circulation. Reputation The organiser commits to fundraising in an ethical way that aligns with the values of Dementia Australia Research Foundation. The organiser or event/activity must not in any way undermine the work of Dementia Australia Research Foundation, discredit Dementia Australia Research Foundation brand, or bring Dementia Australia Research Foundation into disrepute. The organiser must not conduct any events that involve: telemarketing, door knocking or open bucket collections; violent activities; activities that present inherent or unreasonable risk; the sale or promotion of tobacco products or illegal drugs. These events will not be approved by Dementia Australia Research Foundation. Financials Dementia Australia Research Foundation takes no responsibility for the financial outcome of the event/activity and the organiser is responsible for covering any expenses relating to the event including any losses that may arise. The organiser agrees to be honest in their handling of money that they have committed to donate and to not exploit the position as a Community Fundraiser and/or Dementia Australia Research Foundation for personal gain. Alzheimer s Australia does not issue receipt books for community fundraising. Please keep accurate financial records of all donations received. Donations of $2 or more are tax deductible. Ticket purchases, donations of goods and services, or auction items are not tax deductible. Money raised should be returned to Dementia Australia Research Foundation within four weeks of this fundraising activity ending. The organiser may submit a list of names and donation amounts and Dementia Australia Research Foundation will send completed individual receipts for the organiser to distribute. Disclaimer Dementia Australia Research Foundation reserves the right to withdraw its approval of this event/fundraiser and cancel any association at any time if the organiser or event fails to comply with Dementia Australia Research Foundation terms and conditions of fundraising.

5 FUNDRAISING AGREEMENT 1. I (organiser s name) have read and accept the Community Fundraising Terms and Conditions outlined above. 2. I agree to conduct my fundraising activity (fundraiser name) in accordance with those terms and conditions and in a manner which upholds the integrity, professionalism and values of Dementia Australia Research Foundation. 3. I am in suitable physical and mental condition to organise and run this fundraising activity, and have considered any and all risks that may be associated with this event. Print name Signature If you are under 18 years old, please have your parent or guardian complete the following section. Parent/guardian name Parent/guardian signature Please note - we respect the privacy of your personal information. We collect personal details in order to process any donations, provide correct receipt details, and communicate with you as requested. Your personal information will be kept in keeping with current Privacy legislation. Please review our Privacy Policy at WHAT NEXT? Thank you for your generosity and compassion. Your fundraiser will be supporting people living with dementia through funding Australia s best and brightest dementia researchers looking into dementia care, prevention, treatment and finding a cure. Please complete and return to: foundation@dementia.org.au or mail to PO Box 4194 Kingston, ACT 2604