Our Grassroots Grants are designed to help Lodges provide a hand up to assist those in need in their local community.

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Grassroots Initiatives Application Pack: Dollar-for-Dollar Grant (1 July 2018) Dollar-for-Dollar Grant Guidelines Hand Heart Pocket the Charity of Freemasons Queensland works closely with Masonic Lodges at a grassroots level across Queensland and Papua New Guinea to identify areas of need and directly help community initiatives. Our Grassroots Grants are designed to help Lodges provide a hand up to assist those in need in their local community. One of the Grassroots Grants available through Hand Heart Pocket is a Dollar-for-Dollar Grant. This grant provides one dollar in funding for every dollar raised by a Lodge towards an approved community charity initiative. Dollar-for-Dollar Grants are capped at $5,000 per Lodge in any single financial year for initiatives in their community. Does the charity initiative that my Lodge has identified qualify for this grant? Hand Heart Pocket is governed by the Constitution of the Board of Benevolence. In this constitution, there are charitable objects that determine our charitable giving. Therefore, Hand Heart Pocket can only provide grants for initiatives that support a registered charity in Queensland and Papua New Guinea, or for equipment for an individual in need. The initiative must also: - providing relief from poverty, sickness, suffering, distress, misfortune, destitution, helplessness or other need to members of the community, particularly the aged, disadvantaged, disabled, children, those suffering from violence or abuse and those who are unable to properly care for themselves. Preference is given to initiatives that provide a significant impact on the community, that have limited access to other funding sources, and that fall within our five key areas of focus that have been identified through evidence-based research, which forms part of our Strategy 2018-2024. These are: 1. Men s mental and physical health 2. Employment for youth with mental health issues 3. Women s financial and physical security 4. Ageing population 5. Education (necessitous circumstances or disability). For your initiative to be considered for a Dollar-for-Dollar grant from Hand Heart Pocket, the organisation must also have: - Organisations operating in Queensland: Both Charity Tax Concession status and Deductible Gift Recipient (DGR) status under item 1 of the table in Subdivision 30-15 of the Income Tax Assessment Act 1997. You can easily check this on the ABN lookup website at www.abn.business.gov.au

Page 2 - Organisation operating in Papua New Guinea: o Have charitable entity status, registered with the Investment Promotion Authority; o Provide a copy of the organisation s formal constitution; o The constitution must include charitable clauses dealing with member benefits (if relevant) and winding-up. If you need any further assistance or clarification, please do not hesitate to contact Hand Heart Pocket on 07 3493 6000 or email info@handheartpocket.org.au. How does my Lodge apply for a Grassroots Dollar-for-Dollar Grant? 1. Check that your charitable community initiative of choice is eligible. 2. Complete the following Hand Heart Pocket Grassroots Dollar-for-Dollar Application form (ensure all quotes, invoices or supporting documents are attached). 3. Send your Lodge s application to Hand Heart Pocket for the attention of Danielle Chappell either by: o Email to info@handheartpocket.org.au, or o Mail to PO Box 1202, Fortitude Valley QLD 4006. 4. If required, you will need to contact us to organise an Authority to Fundraise for the Lodge to raise the necessary funds to support their Dollar-for-Dollar Grant application. 5. Upon approval by Hand Heart Pocket, the Lodge must transfer their portion of the donation to Hand Heart Pocket to ensure a transparent acquittal process. 6. Your Lodge is encouraged to do a presentation to the charity or individual who is receiving the grant in your community. Hand Heart Pocket may be able to assist with promoting your fundraising and charitable activities once your Dollar-for-Dollar Grant application is approved. Please discuss this with a member of our Marketing Team. 7. Please remember the maximum grant under this program is $5,000 per Lodge in any financial year. Should the project be seeking more than $5,000 but less than $50,000 then the Lodge should refer to our Grassroots: Dollar-for-Dollar Plus Grant. 8. Hand Heart Pocket will require a receipt or invoice to acquit the donation from the recipient or supplier. 9. Work with Hand Heart Pocket to prepare a story for potential publication in the local newspaper and in Hand Heart Pocket s communication materials which could include our website, Facebook page, From the Pocket Newsletter, email updates and Annual Review. V1 Implemented 07/18 Reviewed 07/21 Page 2 of 7

Page 3 Grassroots Initiatives Dollar-for-Dollar Grant Application Form Lodge Name: No.: 1. Details of individual or organisation to receive support Name of individual: Name of organisation: Trading name if different: ABN or Charity Number: Address: Contact name: Position: Phone: Email: Is this person happy to be contacted for publicity purposes? Yes No What does the organisation do? What region does the organisation / group cover? V1 Implemented 07/18 Reviewed 07/21 Page 3 of 7

Page 4 How many people access the organisation / group facilities/services annually? Bank Details of recipient for Donation to be electronically transferred if successful Bank: Account Name: BSB Account Number: Ref: HHP 2. Description of the assistance, equipment or support to be provided or funded. (please include all quotes and invoices) (If more space required - attach typed sheet.) 3. What impact will this donation have on the organisation s clients or service and how many clients will benefit from it annually? 4. Why did the Lodge choose this organisation and initiative to support? V1 Implemented 07/18 Reviewed 07/21 Page 4 of 7

Page 5 5. Grant Details Total Amount: Attach quotes, estimates etc., if available. $ Contribution from Lodge: Requested Dollar for Dollar Grant amount - maximum 50% of total amount of project $ $ ** must not exceed $5,000 in any financial year 6. Payment: (Tick one) The acquittal process requires funds raised by the Lodge to be transferred to Hand Heart Pocket for the grant to be applied. The full amount will then be acquitted by Hand Heart Pocket to the approved recipient. The Lodge is encouraged to hold a formal presentation or celebration event locally with the recipient organisation. o We can confirm that we have a well-supported fundraising plan to assist us in raising the required amount from the Lodge. We anticipate having the funds raised by (an Authority to Fundraise certificate must be obtained from Hand Heart Pocket prior to commencing any fundraising) o We can confirm that we have the funds available and can transfer upon approval. The Lodge will transfer funds by: (Tick one) A Bank transfer or B Cheque 7. Marketing / Publications Upon approval of your application, should your Lodge wish to seek publicity for the grant, then it is a requirement that this is done in consultation with Hand Heart Pocket. Hand Heart Pocket will work with you to prepare a story about the impact of the donation for potential inclusion in the local paper. Hand Heart Pocket will also look to publish the story on its website, Facebook page, newsletter and Annual Review document. This joint approach ensures that all the relevant key messages are covered including the perspective of the Lodge (local angle) and Hand Heart Pocket making it a compelling story. Lodges will be provided with tips to assist with photography. Should you have any information to assist with drafting an article, then please email them to info@handheartpocket.org.au. Please ensure that everyone in the photograph has completed an Authorisation Form which is included in this Dollar-for-Dollar Grant Application Pack. Photos need to be of high quality (at least 300dpi). V1 Implemented 07/18 Reviewed 07/21 Page 5 of 7

Page 6 8. Lodge Approval of Dollar-for-Dollar Grant request: We the undersigned, being Wor. Master and Secretary of No. confirm that we are satisfied that the need described in this application is in-line with the objects and purpose of Board of Benevolence. On behalf of the Brethren, we recommend this application to Hand Heart Pocket. Signed: Wor. Master Signed: Secretary Contact Person: Postal address: Email: Phone No.: PAYMENT DETAILS: Once approved by Hand Heart Pocket, the Lodge may transfer funds by bank transfer or by cheque to: Bank: NAB Queen Street Account Name: Board of Benevolence Operating Account BSB: 084-004 Account Number: 133-925-525 Send this Application to: Office Use Only Danielle Chappell Manager Gift and Wills Hand Heart Pocket Received: PO Box 1202, Fortitude Valley QLD 4006 Or email: info@handheartpocket.org.au BoB Community Benevolent MFOB BOBH V1 Implemented 07/18 Reviewed 07/21 Page 6 of 7

Page 7 Authorisation and Release Form Name: Name of parent / legal guardian (if under 18) Address: Phone: Email: I hereby authorise and grant to Hand Heart Pocket the right to: photograph/record/quote me or my child on film/print and/or other medium, for print, audio and visual reproduction ( the Medium ) edit the Medium into a brochure / newspaper article / film / website / email, television or radio program / commercial advertisement or any other printed or electronic publication which may include other media and publicly facing material; publish/broadcast the Medium in any promotional form at the discretion of Hand Heart Pocket; use the Medium solely for the purpose of publicity, advertising, sales and promotion of Hand Heart Pocket and its related services. I hereby release Hand Heart Pocket from any infringement or violation of personal and/or property rights (including copyright) of any sort whatsoever based upon the use of the Medium. I acknowledge that Hand Heart Pocket own and shall continue to own all rights, title and interest (including copyright) to the Medium. I acknowledge that Hand Heart Pocket are not obliged to use the Medium. I warrant that I have full power to enter into this Authority and Release and that the terms of this Authority and Release do not in any way conflict with any existing commitment on my part with Hand Heart Pocket or any associated entities. This agreement may be terminated at any time by either party by giving one month s notice in writing. Signature (If under 18, must be signed by parent/ legal guardian) Witness Signature V1 Implemented 07/18 Reviewed 07/21 Page 7 of 7