Australian Chinese Charity Foundation Inc. 澳洲華人公益金. Community Project Funding Application Form

Transcription

1 Community Project Funding Application Form This application form should be completed by the organisation seeking community project funding from the Australian Chinese Charity Foundation Inc. By submitting this application, the applicant consents to the Foundation requesting the provision of further information by the applicant to substantiate the application, and to the Foundation taking any steps it considers necessary to verify the authenticity of the application. The amount of assistance for any application in this category can be up to $7,000 or as determined by the Management of ACCF from time to time. An applicant that receives project funding also consents to the disclosure of their names and project details at Foundation events and in Foundation materials. The completed application form can be submitted online or by post to Chairman, Funds & Grants Assessment Committee, P O Box 1174, Strathfield NSW Applications must be received by 5pm on or before. Late applications will not be accepted. Section 1: Applicant details APPLICANT DETAILS Organisation Name Contact Name: Title: Office Address: Postal Address: Telephone: Section 2: About your organisation/group ORGANISATIONAL DETAILS Purpose or aim of your organisation:

2 ABN: Type of legal entity (If you are incorporated please provide your incorporation certificate number): Does your organisation/group have current public liability insurance? (please attach a copy of certificate of currency on request) Section 3 Application overview PROJECT OVERVIEW Project title: Project start date: Project end date: Category*: Amount requested: *Must be one of the following: Aged, Youth, Victims of accidents & illness, Australian registered charities or non-profit organisations, Other special needs Section 4 Application details PROJECT DETAILS Describe your project (What are you trying to achieve/what are your goals?) Why is your project needed? (How and why did you decide on the project? How will it benefit the

3 community?) How are you going to deliver your project? (What steps will you take? Who will manage the project? What needs to be done and who will be doing it?) How will the community benefit from your project? Will you work with other organisation or individuals when planning or delivering this project? (For example, seeking advice, jointly planning or delivering the project, etc.)

4 Section 5 Project Budget details An application will not be considered without financial information being attached. Please provide details of income and expenditure for your project. All figures are GST inclusive. The total in the income column MUST equal the total in the expenditure column. Quotes must be supplied where applicable. Description Budget Income (please supply all income to be used for your project including funding from other sources) Expenditure (itemised expenses)* Total Total * Please indicate where the grant money requested will be used with an asterisk (*) Section 6 What would be your organisation s contribution to the project? Section 7 How would your organisation continue the project after the expiration of the Foundation funding?

5 Section 8 Support documents: If possible, please provide the following documents Annual Report Latest financial statements showing income and expenditure Copy of certificate of currency Any other relevant documents Section 9 Declaration I agree that the information in this application and the attachments are, to the best of my knowledge, true and correct. I shall inform the Foundation of any changes to the information or circumstances that may affect this application. I understand that this is an application only and may not necessarily result in funding approval. Name of applicant or representative of applicant organisation (please print) Contact Telephone No. Signature: Date: