2017 AEP Application Form

APPLICATION FORM

Active Enabler Programme

*All fields are mandatory, unless otherwise indicated.

For Group Application: Two applicants aged 18 years and above.

At least one applicant must be a Singaporean.

(Please complete information under “Applicant 1” and “Applicant 2” sections)

For Organisation Application: One Singaporean applicant is required on behalf of the organisation. Organisation must be a society or company registered in Singapore with Registry of Societies (ROS) or the Accounting and Corporate Regulatory Authority (ACRA).
(Please complete information under “Organisation” section)

All applications must be submitted byThursday, 31 May 2018, 2359hrs.

All successful applications will be subject to the acceptance of terms and conditions for the Active Enabler Programme.

I am applying for (please select one item only):

Endorsement only
Active Enabler Sports Expertise (Fitness/Sports)
Active Enabler Grant (Project)
Active Enabler Grant (Mass Event)

All successful applications will be allocated GetActive! Singapore premiums for the projected number of participants.

APPLICANT 1 (FOR GROUP APPLICATION) #Delete wherever necessary
Name of Group (if applicable):
Salutation: / (Dr/Mr/Mrs/Mdm/Ms) #
Name of Applicant (as in NRIC):
NRIC No.:
Nationality:
Occupation / Designation:
Gender:
Date of Birth:
Address (in Singapore):
Postal Code:
Phone/ Mobile Number (in Singapore):
Email Address:
APPLICANT 2 #Delete wherever necessary
Salutation: / (Dr/Mr/Mrs/Mdm/Ms) #
Name of Applicant (as in NRIC):
(as in Passport for Non-Singaporean):
NRIC No. / Passport No. for Non-Singaporean.:
Nationality:
Occupation / Designation:
Gender:
Date of Birth:
Address (in Singapore):
Postal Code:
Phone/ Mobile Number (in Singapore):
Email Address:
ORGANISATION(FOR ORGANISATION APPLICATION) #Delete wherever necessary
Name of Organisation:
Unique Entity Number (UEN):
(if applicable)
Organisation Type: / (Limited Liability Partnership / Private Limited / Company limited by Guarantee / Public Limited Company/ Societies/ Others )#
Nature of Business:
Founding Year:
Number of Employees:
Address of Organisation (in Singapore):
Postal Code:
ORGANISATION REPRESENTATIVE
Salutation: / (Dr/Mr/Mrs/Mdm/Ms) #
Name of Applicant (as in NRIC):
NRIC No.:
Nationality:
Designation:
Phone/ Mobile Number (in Singapore):
Email Address:
EVENT/PROJECT DETAILS #Delete wherever necessary
General Information
Event/Project Title:
Event/Project date(s) and time (start):
(Event is to be held between 28 July to 9 August 2018)
Event/Project venue:
Event/Project Summary:
Summary must include the following:
▪Brief description of event/project
▪Objectives and outcomes you would like to achieve
(In less than 500 words)
For application of the Active Enabler Grant, you are required to attacha detailed proposal (inclusive of budget) for evaluation. Please refer to attached template i.e. Annex - Grant Proposal
Describe the National Day celebratory element of your event/project.
(For application of the Project/Mass Event Grant only)
Describe how your event is inspiring / innovative or how the element of ‘care’ is incorporated.
Is your Event/Project open to the public?
Please note that for Mass Event Grant application, the event has to be open to the public. / (Yes/No)#
(For application of the Active Enabler Sports Expertise only)
Please indicate the type of activity (choose only ONE (1) activity from either the Fitness or Sports categories under Annex-Sports Expertise
(For application of the Active Enabler Sports Expertise only)
I would like my Group Fitness session to be held at:
 my own venue
 GetActive! Singapore Festival site
If you choose to hold your event at the GetActive! Festival sites, your participants would also be able to enjoy a wide array of activities available at the sites. / Please put a tick (√) against your preferred site if you would like yourGroup Fitness activity to be held at the GetActive! Singapore Festival site.
GetActive! Singapore Festival sites / Dates available
Sports Hub / 28 Jul to 8 Aug 2018
Tampines (OTH) / 28 to 29 Jul 2018
Jurong East (Besides MRT)
Toa Payoh Hub
Chinatown (Infront of People’s Park Complex)
Punggol (Punggol Waterway The Plaza) / 4 to 5 Aug 2018
Sembawang (Opp MRT Hardcourt)
Ang Mo Kio (Central Stage)
Little India (Beside Masjid Angullia)
Geylang Serai (Malay Village)
Target Audience
Who are the intended participants?
Estimated total number of participants:
The number ofGetActive! Singapore Premiums approved will be based on the total number of participants indicated here.
If you are collecting registration fee for participation, please indicate the projected revenue.
If revenue is collected, you may be required to submit a detailed project budget.
PROJECT BUDGET(FOR ACTIVE ENABLER GRANT APPLICATION ONLY)
Amount requested under the
Active Enabler Grant: / (S$)
Total Projected Expenditure: / (S$)
Breakdown of Projected Expenditure
Note:

Items that qualify for funding includes event management, publicity, marketing and operating costs directly related to the event/project.

Items that do not qualify for funding includes start-up costs, capital expenditure (e.g. purchase of office equipment/ assets, computer infrastructure, registration/licensing fees), cash prizes, expenses incurred outside of Singapore, expenses relating to fundraising/crowdfunding events, or incurred for any form of religious/political activities.

This list is non-exhaustive. Sport Singapore reserves the right to reject cost items that do not meet the objective and eligibility criteria of the Active Enabler Grant. To ensure that more can benefit, ActiveEnabler Grant only supports projects/cost items that are not funded by any other entity.
Please indicate all items of the projected expenditure that will be incurred for the event/project in your detailed proposal.
*Please note that the event/project should not be profit-making in nature, nor contain any profit-making element(s).
Please list down other sources of funding that you intend to apply to support this event/project
These may include sponsorships, grants, donations from foundations / organisations, etc.
Particulars of Source / Funding amount / Funding Status
WHAT RELEVANT EXPERIENCE DOES YOUR TEAM HAVE IN CARRYING OUT THIS EVENT /PROJECT?(FOR ACTIVE ENABLER GRANT APPLICATION ONLY)
*DECLARATION (Please select one only)

/ (FOR GROUP APPLICATION)
We, on behalf of the group, declare that the information in this application and the supporting documents are true and correct to the best of my knowledge; and that all members of the group agree to abide by all the terms and conditions of Active Enabler Programme.
We, on behalf of the group, declare that all the members of the group:
(a) are not undischarged bankrupts in Singapore or elsewhere; and
(b) have not entered into a compromise or scheme of arrangement with creditors that is still in operation, and have not proposed to enter into any such compromise or scheme of arrangement, in Singapore or elsewhere.
/ (FOR ORGANISATION APPLICATION)
I, on behalf of the organisation, declare that the information in this application and the supporting documents are true and correct to the best of my knowledge; and that the organisation agrees to abide by all the terms and conditions of Active Enabler Programme.
I, on behalf of the organisation, declare that the organisation:
(a) is not insolvent or in the process of becoming insolvent (including having a receiver, a receiver and manager, a judicial manager or an equivalent person appointed) in Singapore or elsewhere; and
(b) has not entered into a compromise or scheme of arrangement with its creditors that is still in operation, and has not proposed to enter into any such compromise or scheme of arrangement, in Singapore or elsewhere.
Group Application
Name of Applicant 1 / Signature of Applicant 1 / Date of Application
Name of Applicant 2 / Signature of Applicant 2 / Date of Application
Organisation Application
Name of Organisation Representative / Signature of Organisation Representative / Name of Organisation and Organisation Stamp / Date of Application

Please email your form

OR alternatively mail it to:

Active Enabler Programme Secretariat

Sport Singapore

3 Stadium DriveSingapore 397630

For feedback and other enquiries, please email at

ANNEX – Grant Proposal

EVENT/PROJECT TITLE
EVENT/PROJECT OBJECTIVES
DESCRIPTION OF MECHANICS
HOW DOES THE EVENT/PROJECT ENCOURAGE CELEBRATING NATIONAL DAY THROUGH SPORTS?
EVENT/PROJECT TIMELINE (To include key project milestones i.e. registration, rehearsal, set-up, actual day of implementation etc…)
RISK MANAGEMENT PLAN(To indicate potential hazards associated with the event/project, evaluation of the hazards and their control measures)
Hazard Identification / Risk Control
S/N / Activity / Hazard / Possible risk / Risk Control
Breakdown of Projected Expenditure
Please indicate all items of the projected expenditure that will be incurred for the event/project. The below itemised list serves as a template for illustrative purposes only and should be customised according to respective event/project’s requirements.
*Please note that the event/project should not be profit-making in nature, nor contain any profit-making element/s.
*Item / *Projected Expenditure (S$)
Event Management
Venue Rental
Production
Publicity
Total

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