MARGARET ATTWOOD GRANT ROUND

APPLICATION FORM

SMALL GRANTS OF UP TO $10,000

This form is to apply for funding from Greater Shepparton Foundation via the Margaret Attwood Grant Round for grants up to $10,000.

GSF is seeking to support small grass roots projects that deliver big impact for our community!

Applications Open – Monday, April 22 at 9am

Application Close – Thursday, May 16 at 5pm

Greater Shepparton Foundation in partnership with the Margaret Attwood Trust invites local not for profit organisations to apply for funds to support projects that address an immediate or unmet need which, importantly, aligns with the Foundation’s vision of inclusive, interconnected communities where everybody has an equal opportunity to participate.

Please read the GUIDELINES FOR FUNDING document before completing this form.
Applications must be completed on line via this online application form.
All applicants will be contacted for more information if required and notification of the outcome will aim to be within 4 weeks of submission.
A final report - Evaluation and Acquittal form is required to be submitted online no later than 12 months after the funding is granted. Failure to supply an acquittal will jeopardise future applications.
For any further inquires email: amanda@greatershepparton.foundation

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 application at a later date.

Applicant Information

1. Organisation Name *

1.1 Organisation address *

1.2 Organisation website

1.3 Project title *

1.4 Amount of funding you are applying for *

1.5 Does your organisation have tax deductible gift status? *

YesNo

Please attach a copy of the Tax Office Certification (accepted files jpg, jpeg, png, pdf)

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1.6 Organisation ABN *

1.7 How long has your organisation been established? *

1.8 What is the primary objective of your organisation? (maximum 100 words/500 characters) *

1.9 Provide a brief overview of your organisation's top strategic priorities. (maximum 100 words/500 characters) *

1.10 Please provide a breakdown by percentage of funding sources for your organisation. Total percentrage must equal 100, please use whole numbers.

Government funding/contracts/grants

Services and fees

Investment/interest

Philanthropic grants

Fundraising

Other

1.11 Person responsible for the project

First Name *

Last Name *

Position *

Email of responsible person *

Phone *

Postal Address (all written correspondence will be sent to this address) *

1.13 Will funds be received and acquitted by the above organisation or by another auspicing organisation on your behalf? *

Yes, as above (if yes proceed to question 2)No - other

If you selected 'no - other' above - Name of the auspicing organisation

Auspicing organisations ABN

Relationship of the auspicing organisation to the delivery organisation

Name of responsible person in the auspicing organisation

Position of the responsible person in the auspicing organisation

Email of the responsible person in the auspicing organisation

Phone number of the responsible person in the auspicing organisation

Postal address of the auspicing organisation

Does the auspicing organisation currently have deductible gift status?

YesNo

If yes, please attach a copy of the Tax Office certification of the auspicing organisation (accepted files - jpg, jpeg, png, pdf)

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The Project

2. Project description (maximum 100 words/500 characters) *

2.2 Detail the aims and objectives of the project. Please list 3 to 5 project objectives and briefly describe how the funding requested will be used to support these objectives (maximum 300 words/1500 characters) *

2.3 How/when will the project be implemented. (maximum 200 words/1000 characters) *

Please upload a project timeline. (Accepted files jpg, jpeg, png, pdf) *

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2.4 Project catchment/physical location (provide the address where applicable). Please describe whereabouts (geographically) in the region the project will serve. *

2.5 Groups served and alignment with GSF focus areas. Please detail which groups/sectors your program aims to assist and how they align with GSF focus areas. (Maximum 200 words/1000 characters) *

2.6 Does the project extend beyond the Greater Shepparton region? *

YesNo

If you answered 'yes' to the question above, please indicate the total region. *

Project Beneficiary Information

3. What is the need targeted by your project? (maximum 100 words/500 characters) *

3.1 Please describe the primary beneficiaries and issues (select all categories that apply)

3.2 How many individuals do you expect to benefit from the project? *

Outcomes and Evaluation

4. Greater Shepparton Foundation will require a report from your organisation evaluating the delivery of the project or service against the criteria detailed in this application. A final report - Evaluation and Acquittal form and partnership survey is required to be submitted at a date to be determined (usually at 12 months after the funding is granted). Failure to supply an acquittal will jeopardise future applications. *

I agree

4.1 For each project objective listed at 2.1 how will it be measured and what data will you use to measure them? (maximum 200 words/1000 characters) *

4.2 What results do you expect to achieve? Please outline these results in short-term, medium-term and long-term outcomes. (Maximum 300 words/1500 characters) *

Collaboration

5. Describe any relevant partnerships (funding or in-kind) that will support your project. *

5.1 Do you know of any other programs in Greater Shepparton that have the same/similar aims and objectives to yours? How will your proposal differ to existing programs? How does your program fit with other agencies/groups delivering similar services within the area? (Maximum 100 words/500 characters) *

5.2 Will a fee be charged for this service? *

YesNo

If you answered 'yes' to the above question, who will be charged and how much?

5.3 What are your plans if funding from Greater Shepparton Foundation is not available? (Maximum 100 words/500 characters) *

5.4 How will the program be sustained in future years? (Maximum 100 words/500 characters) *

Budget

6. Project Budget - INCOME

Govt. Grants

Service fees/charges

Donations

Agency Contributions

Greater Shepparton Foundation

Other income source 1 (if applicable)

Other income source 2 (if applicable)

Other income source 3 (if applicable)

TOTAL INCOME

6.1 Project Budget - EXPENDITURE

Salaries

Travel/vehicle costs

Catering

Administration Expenses

Project Equipment

Other Expenditure 1 (if applicable)

Other Expenditure 2 (If applicable)

Other Expenditure 3 (if applicable)

Other Expenditure 4 (if applicable)

TOTAL EXPENDITURE

Surplus / Deficit

Please upload your most recent audited annual financial statements if available (file types accepted are jpg, jpeg, png, pdf)

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If you have one, please upload your most recent Annual Report (file types accepted are jpg, jpeg, png, pdf

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Declaration

Name of person completing this declaration

First Name *

Last Name *

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

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
0447 400 443
info@greaterhshepparton.foundation

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