ACQUITTAL REPORT (SMALL GRANTS)

To be completed and submitted no later than 12 months after the funding is granted.
Failure to supply an acquittal will jeopardise future applications.

To SAVE THE PROGRESS of your form , please scroll to the bottom of the form and click ' Save and complete later '. You will then receive a link to go back in and complete your acquittal at a later date.

Recipient Details

Organisation Name *

Total amount of GSF grant *

Year GSF grant received *

Person responsible for the project

First Name *

Last Name *

Position *

Email of responsible person *

Phone *

The Project

Project name:

Please provide a brief description of the project you received funding for (e.g. [The name of the project] addressed the [main issues/problems/needs] for the purpose of benefiting [population group/organisation] through [activity description]. *

Project location(s) *

Project date(s) *

Attendees/participants *

Staff

Volunteers

Partner organisations

What type of project information/data was collected? *

Participant demographics (e.g. age, gender, culture, languages spoken)Participant engagement (e.g. attendance, level of participation)Formal feedback on project (e.g. benefits, challenges, recommendations)Informal feedback (e.g. casual conversations/observations) Other

If 'Other' please specify

Project Outcomes

Please provide a brief description of the project's participants (e.g. number, age, gender, cultural and language diversity) *

What project benefits were identified? Where was the information sourced from? *

Did the project achieve the expected outcomes stated in your Application Form? If so, which outcomes? Please indicate information source supporting outcome achievements. If not, what issues arose that prevented outcome expectations from being met? *

Reflections

Overall, how would you rate your experience of Greater Shepparton Foundation's Small Grant's program? *

What recommendations would you make to the Greater Shepparton Foundation to improve its Small Grants program? *

Testimonial

Please provide a short testimonial regarding the support that your organisation received from GSF for your project. Specifically, how the support from GSF contributed to the success of the project and what it meant to your organisation. (50 words) Note, your testimonial may be used on the Greater Shepparton Foundation website, in social media and in relevant media promotions. *

Name of person providing the testimonial

First Name *

Last Name *

Position of person providing the testimonial *

Please upload a photo relevant to your project to use with the testimonial. (jpg, jpeg or png) *

Browse

I provide approval for Greater Shepparton Foundation to use/publish the above testimony and photo(s).

YesNo

Expenditure

Item *

$ funded by GSF

$ funded by other sources

Total $ *

Total project expenditure *

Please explain any overall project surplus / deficit (if applicable) *

Please provide any other comments or information applicable to the program/grant expenditure. *

Declaration

I declare that the information I have provided above is true and correct. *

Name of person completing this acquittal

Full Name *

Date *

Save and Complete Later

Greater Shepparton Foundation acknowledges it operates on the lands of the Yorta Yorta and Bangerang peoples. We honor and pay our respect to Elders and leaders, past, present and emerging. We respectfully use the term “First Nations’ People” to honour all First Nations’ People who benefit from our activities and live on the Yorta Yorta and Bangerang.

CONTACT US
PO Box 848
Shepparton VIC 3632
0410 561 934
info@greaterhshepparton.foundation

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