Towong Community Bushfire Disaster Relief FundGrant Application (Round 7)

Towong Community Bushfire Disaster Relief Fund
Grant Application (Round 7)

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SECTION ONE

PROJECT

Project name:

Amount requested:

Please enter without any symbols (eg. $)

Round Seven of the grant program is primarily targeting applications up to $50,000. Applications for funding up to $100,000 may, however, be considered after consultation with Border Trust. Please contact Glenys on glenysa@bordertrust.org.au or 0447 684 506 to discuss your application beforehand if this is the case.

ORGANISATION DETAILS

Organisation name:

Main activity of organisation (maximum 100 words):

LOCATION ADDRESS

Street:

City:

State:

Postcode:

MAIL ADDRESS

Street or PO Box:

City:

State:

Post Code:

Organisation email::

Organisation phone::

Website:

N/A if not applicable

Facebook address:

N/A if not applicable

Instagram address:

N/A if not applicable

HEAD OF ORGANISATION (CEO or equivalent)

First name:

Last name:

Position title:

Mobile:

Email:

Is the Project Manager different to the Head of Organisation?

PROJECT MANAGER (if different to Head of Organisation)

First name:

Last name:

Position title:

Mobile:

Email:

ORGANISATION GOVERNANCE STATUS

ABN:

Please upload an electronic copy of your ABN, if applicable.

Does the organisation have:

DGR (Deductible Gift Recipients) Item 1 Charitable Organisation Status?

Income Tax Exempt status?

ACNC (Australian Charities & Not for Profit Commission) registration?

Please provide a copy of ATO endorsements.

Upload a copy of your ATO endorsements, using the Choose File button below. Click add another endorsement if you need to include more than one (maximum 3 files).

Note: if you click on 'add another endorsement' you will either need to upload a document in this second section or click on the 'remove' link to remove the 'choose file' box.

PROJECT TIMEFRAME

Anticipated start date:

Anticipated end date:

FINANCIAL INFORMATION

Provide copies of your organisations financial details as per the following:

Audited accounts: Please click on the Choose File button below to upload a copy of your audited accounts.

Year to date financials: Please click on the Choose File button below to upload a copy of your year to date financials.

Auditor or treasurer's details

Name:

Phone contact:

Email:

COMMITTEE OR DEPARTMENT MANAGEMENT (Office Bearers Only)

President:

President's phone:

Presiden's email:

Secretary:

Secretary's phone:

Secretary's email:

Treasurer:

Treasurer's phone:

Treasurer's email:

LOCATION INFORMATION

Where within the Towong Shire will the beneficiaries of your project come from? ie. Nariel Valley, Corryong, etc. (maximum 50 words).

FUNDING

Please provide funding details for this project as applicable, including previous funding and funding external to this application.
Click on the Add another funding source link to add additional funding bodies.

Funding body:

Year:

Current status:

Amount:

Please enter without any symbols (eg. $)

Please detail any previous 2019/2020 Bushfire Recovery funding received by your organisation from other sources. (insert not applicable as appropriate).

Does the funding received relate to the project referred to in this application?

Has work commenced?

Is this application for a further stage of an existing project?

What is the status of the project overall?

Has your organisation previously received funding from Border Trust? If so please specify year/project/amount.

SECTION TWO

PROJECT DETAILS

FOCUS AREAS

This grant round has specific focus areas as they relate to the 2019/2020 bushfires. Please tick which focus area/s your application meets:

Health and wellbeing initiatives for the long-term recovery of people affected by the 2019/2020 fires Programs, events and initiatives that support the development of emerging leaders in the bushfire affected areas Events and initiatives that promote social cohesion, reduce social isolation, build community resilience, and connect bushfire affected communities Projects addressing the relief, recovery and re-establishing of a community.

What does your organisation do? (maximum 350 words)

Project description (maximum 350 words)

Summary of project (maximum 100 words)

Why does this work need to be done? (maximum 250 words)

PERMISSIONS & APPROVALS

Does your project involve work on a community asset such as a hall?

Do you have permission from the landowner for this project?

Are Council approval and permits required for this project?

LETTERS OF SUPPORT

Who have you consulted with? (maximum 100 words)

We strongly recommend letters of support are obtained & submitted with your application. We encourage letters of support that demonstrate partner and community support. Please use the Choose File button below to add your letters. If you need to add another letter, click on the add another letter of support link (a maximum of three files can be uploaded).

Note: if you click on 'add another letter of support' you will either need to upload a document in this second section or click on the 'remove' link to remove the 'choose file' box.

What will you do? (maximum 300 words)

Who will benefit? (maximum 200 words)

Expenditure (maximum 100 words)

PROJECT BUDGET

A full budget and quote/s to support the amount requested are to be provided as part of your application. Any additional documentation can be emailed to admin@bordertrust.org.au.

To download the Budget Template, right click here Project Budget Template and click “Open link in a new tab” to download. Use the Budget Template to provide details of:
INCOME: details of other funding (confirmed and applied for) & include in kind contributions
EXPENDITURE: breakdown of individual line items (eg, equipment, travel, admin, etc).
Upload completed Project Budget document using 'Choose File' button below.

Upload your quotes and other relevant documents, using the Choose File button below - pdfs or Office documents only. Click add another document if you need to include more than one (maximum 5 files).

Note: if you click on 'add another document' you will either need to upload a document in this second section or click on the 'remove' link to remove the 'choose file' box.

What do you want to achieve and how will you measure this? (maximum 250 words)

RECOGNITION OF GRANT

All successful grant applicants will be asked to recognise the contribution from Border Trust and the Towong Community Bushfire Disaster Relief Fund, by acknowledging both organisations in newsletters, social media posts and on your organisation’s website etc. We will provide an appropriate script and logo/s for this purpose.

EVALUATION & ACQUITTAL OF THE PROJECT

All successful grant applicants will be required to provide an Acquittal Report. This will include a written report, photos and stories resulting from your project. We will provide a link to the online acquittal form in due course.

SECTION THREE

DECLARATION

I HEREBY CONFIRM THAT all details contained in this Application are a true reflection of the status of our organisation and the project that we wish to undertake.

The signatory below is the Head ofthe Organisation and has been authorised to acquit the project on its behalf.

DECLARED for and on behalf of:

Organisation name:

Head of Organisation:

CEO or equivalent.

Position:

Date:

Please enter below one email address that BorderTrust can use to email you a copy of your completed submission.

Please note that your application may take a while to submit, particularly if you have attached large files. Please do not navigate away from this page until you see the confirmation screen.

CHECKLIST FOR COMPLETION OF FULL APPLICATION

Read document 'General Information for Grant Applicants'.Submit any associated documentation, including:
- Australian Tax Office status document (DGR & TCC) if applicable
- ABN & ACNC Registration
- Financial reports (Border Trust Template and most recent balance sheet & income statements)
- Letters of Support
- Budget including details of other funding (confirmed and applied for) for this project
- Quotes.
All questions have been answered.Declaration complete.

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