(LLS office use only)
Aboriginal Land Management Team Grant Application Form – 2015-16
This formis to be used to apply for funding under any Hunter Local Land Services (LLS) Grants Programs. Please refer to the Grants Program Guidelines for further information about the terms and conditions of applying for LLS funding.
Funding for LLS Grants programs is by New South Wales Government’sCatchment Action NSW program.
1. PROGRAM DETAILSWhich LLS District is your organisation in? / Lower Hunter
(Lake Macquarie, Newcastle, Port Stephens, Cessnock, Maitland & Dungog LGAs)
Upper Hunter
(Singleton, Muswellbrook & Upper Hunter LGAs)
Manning-Great Lakes
(Great Lakes, Gloucester & Greater Taree LGAs)
Note: Your application may also be considered for funding under other LLS Programs.
2. APPLICANT AND PROPERTY DETAILS
Applicant (The name at the Applicant should match the name of ABN holder if provided)
Contact Person / Mr/Mrs/Ms
Landowner(s)(if not applicant) / Mr/Mrs/Ms
Is the applicant an Aboriginal or Torres Strait Islander individual or organisation? / Yes No
Property Address (Project Location) / Applicant Postal Address
Suburb: / Postcode / Suburb: / Postcode
Contact Details
Telephone / Home: / Bus: / Mob:
Project Location:
Lot/DP:
Property Identification Code (PIC):
LGA:
Area of proposed project (Ha)
Total Area of Property (Ha)
ABN and GST Status
Registered Business name:
Are you currently registered for GST? / Yes No / ABN:
Are you an incorporated association?
If not, either provide the name and ABN of the auspicing organisation, or write ‘pay supplier’ if you would like LLS to pay your expenses directly (no auspicing required for this option): / Incorporated No.: ______
Group membership
Are you affiliated with an Industry, Landcare or community group / Yes No
Group name: ______
3. ABOUT YOUR ORGANISATION
Please provide an outline of your group/organisation’s role in sustainable natural resource and land management:
How long has your Aboriginal group/organisation been operating for?
4. PROJECT PROPOSAL
Please select from the following list which type of activities are likely to be involved/benefit/covered by your project:
Activity Type / Yes or No / Details:
Aboriginal land management team (or development of an Aboriginal land management team) / Yes No
(If no, ineligible to apply)
Bush regeneration, seed collection or propagation / Yes No
Conservation of native flora or fauna / Yes No
Pest animal control / Yes No
Vegetation management plan development / Yes No
Waterway / sea management and conservation / Yes No
Other: / Yes No
4. PROJECT PROPOSAL continued
Name of the project:
Number of Aboriginal people to be employed/trained:
Area (Ha) of on-ground management proposed:
Number of project partnership (if applicable):
Brief description of proposed project:
A short description of how your project will building capacity of ALMTs to deliver on-ground works on Aboriginal land and other land.
Have you previously been funded to undertake a project with the same/similar outcomes as the project you are seeking funding for in this application? / Yes No
Details:
Describe any innovation/improvements to be used in your project:
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Aboriginal Land Management Team Grant Program – Application
6. PROJECT PLANWhat are you proposing to achieve through implementing the project (outcomes)?
Examples: re-establish native vegetation; train and employ Aboriginal land management team members, raise community awareness / What works or activities will you undertake?
Examples: Plant & establish 500 trees; development of vegetation management plan, control 2ha of lantana & blackberry / Completion date?
(month & year)
(Implementation of projects must be completed by 30 June 2016
according to project plan timeframes)
7. PROJECT BUDGET
Note: For estimate purposes landholders/community groups should cost their in-kind labour component at $30/hour.
LLS funding is provided exclusive of GST. Please see the LLS’s GST Fact Sheet for more advice on funding and the GST implications.
Proposed activity/work/action Examples: Plant trees, erect electric fence / Unit of Measure / Quantity / Unit Cost (excl GST) / Total Item Cost (Excl GST) / LLS Funds Sought (Excl GST) / Own Cash Contribution (Excl GST) / Own Labour In-kind @$30/hr / Total – funds sought + in kind+ cash contribution (Excl. GST) / GST
TOTALS
NOTE: An excel version of the budget sheet is available from your Hunter LLS Contact Officer upon request.
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Aboriginal Land Management Team Grant Program – Application
8. MONITORING, MAINTENANCE AND REPORTINGHow will you monitor whether your project is achieving the Outcomes?
(BOLD rows are mandatory) / Tick adopted monitoring techniques. / Frequency or due date
Photo-point monitoring /
Before and after photos of works /
Step Point transect for assessing groundcover /
Event evaluation sheets /
Attendance records /
Pasture composition quadrats /
Tree survival rates /
Final Report /
Grazing records/Plan /
8. ABORIGINAL CULTURAL HERITAGE AND CONSULTATION
Checklist Questions / Yes / No
Do you know of any Aboriginal sites or objects on your property or in the immediate area?
Are you aware of any Aboriginal history, stories or significant events that took place on your property or in the immediate area? If YES, please provide a brief description below.
Is your project area located near a river, stream, lake, wetlands or watercourse?
Does your project area contain any of the following landforms: rocky or sandy hills, mountains, claypans, caves, sandstone overhangs?
Will there be any native vegetation removed permanently?
Are you interested in planting any native vegetation on your property?
Will there be any ground disturbance involved in the project? If YES, please provide brief description below.
Is the property on private (freehold) land?
Do you give permission for relevant project information to be provided to the Local Aboriginal Land Council for the purpose of cultural heritage assessment?
Other Notes:
10. PUBLIC LIABILITY INSURANCE
Yes / No
I currently have Public Liability Insurance and a copy is attached
If you currently don’t have this insurance coverage, are you willing to acquire $10 million public liability coverage, if you are successful?
11. MAP OF PROPOSED PROJECT WORKS
Contact your Hunter LLS contactofficer to discuss your project and to develop a map of your project area and works proposed for inclusion in your application.
You may also wish to provide photographs or a sketch of the proposed project site in the space provided below to support your application.
12. CONFLICT OF INTERESTOutline any conflict of interest you may have with the business or any director or staff of Hunter LLS
13. OTHER FUNDING
Has your group previously worked with, or received funding from, the following organisations?
Hunter Local Land Services, Department of Primary Industries, Hunter-Central Rivers CMA or Livestock Health and Pest Authority
If yes, please provide brief details of any current or previous grants, or financial assistance you have received relevant to this project.
Do you have any other related funding applications currently under consideration?
YES / NO (If Yes, please list)
Before signing please ensure your application is complete in all sections as incomplete applications will not be considered.
Successful applicants will need to adhere to the terms and conditions outlined in the Program guidelines.
If a company or organisation, the applicant must be an authorised representative of the entity.
I,Name of applicant (please print)
as the applicant confirm that all details outlined in this application are true and correct.
Signature of applicant / Date
If you are applying to undertake a project on land of which you are not the owner, the landowner must also sign the application for private holdings or the responsible entity must sign for public land. If the landowner or responsible entity is a company or organisation, the signatory must be an authorised representative of the entity.
I,Name of land owner or responsible entity (please print)
as the landowner (or responsible entity) grant permission for the applicant to undertake the project on the land and confirm that I will be bound to all details outlined in this application.
Signature of landowner / Date
Submission details for each Program are presented in the Program guidelines.
Applicants Checklist for Grant Application
Do you have in your application for submission... / Yes / NoHave you attached your LLS generated map? / Yes / No
Have you attached a copy of your Public Liability Insurance? / Yes / No
Has the land owner or responsible entity signed the application? / Yes / No
Does the person/entity responsible for the agreement name match the name against the ABN number (if applicable)? / Yes / No
Are you aware of LLS minimum activity standards and/or activity definitions for projects and that you will be required to deliver your project in accordance with these? / Yes / No
Have you answered every question? / Yes / No
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Aboriginal Land Management Team Grant Program – Application