Arts and Cultural Grants Program 2017/2018

ARTS AND CULTURAL GRANTS PROGRAM 2017/2018

ROUND 3 APPLICATION FORM

CATEGORY 6: CULTURAL PROMOTION (Up to $2,000)

Applications open until end of financial year or until all funds expended

Applicants are encouraged to discuss their project with the grants officer before applying as they can provide helpful advice on how to complete the application form and any permits that may be required for the project.

Name of Applicant
Address
Phone
Email
Contact Person
Position
Name of Project
Grant Amount Sought
($2,000 maximum)
ABN
GST status / Registered Not Registered
OFFICE USE ONLY
Date Application Received
File Number

ELIGIBILITY CRITERIA
Please note, your project must meet this criteria in order to proceed to the assessment stage.

a) Will your project be held within the City of Adelaide boundary?
Yes No
b) Is your project taking place in one of Adelaide’s Park Lands or Squares?
Yes No
If yes, please confirm you have submitted an ‘Events in the City Booking Application’.
Applications are available from the City of Adelaide’s website –

Yes, I have submitted an ‘Events in the City Booking Application’.
c) Is your project taking place on private property?
Yes No
If yes, please confirm you have approval from the land / building owner.
Yes, I have approval from the land / building owner and a copy has been provided in writing as part of my support material at section 3.5.
d) Is your organisation not-for-profit?
Yes No
e) How is your organisation constituted?
Incorporated Association
Unincorporated group auspiced by an Incorporated Association
N/A (I am an individual in the Cultural Promotion category)
Other - Please specify ______
f) How is your organisation / auspicing organisation managed?
Management Committee
Board of Management
Advisory Board
N/A (I am an individual in the Cultural Promotion category)
Other - Please specify ______
g) Do you / your organisation have any outstanding reporting or debts to the City of Adelaide?
Yes No
If yes please provide details.
h) Working with children
Does the project (at any stage) involve working with children and young people aged under 18 years?
Yes No
If yes, have you read, and do you comply with Arts South Australia's Protocols for Working with Children in Art?
Protocols can be downloaded from:
www.arts.sa.gov.au/protocols-for-working-with-children-in-art/
Yes No

ASSESSMENT CRITERIA 1 - Fully Developed Proposal

(40% of assessment)

1.1 Please select the project type/s that best describes your project

Performance Event/s
Workshop/s
Mentorship/s
Public Art Project / Community Art Project/s
Multicultural Festival
Community Event/s
Other (please provide details)
…………………………………………………………………………...
1.2 Project Dates / Start Date ______End Date ______
1.3 Project Description
Please describe your project, its aims and what it will deliver
1.4 Proposed location(s) of project e.g. where your project is taking place - street(s), venue name, name of Park Land
1.5 Is there a cost for the public to attend your project?
Please note: projects that are free or provide a free component are viewed more favourably. / Free (100%)
Cost (100%)
Combination (please complete percentages below)
What percentage is free? ------%
What percentage is full price? ------%
What percentage is concession or reduced price? ------%
1.6 What is the total anticipated attendance at your project? Please explain how you have calculated your attendance figure.
1.7 Please provide a timeline for your project
Please include dates and times of specific events
1.8 Please respond to the following questions:
a) How will your project or activity enable your cultural/creative enterprise to thrive and to promote cultural/creative activity and enterprise in the City?
AND
b) How will your activity surprise, delight and attract people to the City?
1.9 Please provide details of any consultation you have undertaken with businesses / stakeholders that may be affected by your project
Evidence of this consultation can be provided as support material at section 3.5
1.10 Please provide details on the marketing you will undertake for your project
e.g. social media campaign, printed promotional material distributed, paid advertising, press release distributed, acknowledgement at event
1.11 Please identify how you will acknowledge the City of Adelaide’s support of your project
1.12 Preliminary Risk Assessment
Please identify any risks / hazards associated with your project by completing the form below.
Please see Attachment A for instructions on how to complete this form.
Task or Activity / Potential Hazards/Consequences / Class of
Risk / Action Required To Control Risk/s

INCOME AND EXPENDITURE BUDGET
1.13 Please complete the Income and Expenditure Budget below, indicating in bold what the City of Adelaide’s funds will be directly used for.

Please include fees and charges for City of Adelaide services as the City of Adelaide will not provide in-kind support via the waiving of fees. See ‘Attachment B: Contact and Costing Details for City of Adelaide Services’ for more information.

INCOME / $ / EXPENDITURE / $
GRANTS / DONATIONS / WAGES / ASSOCIATED COSTS
City of Adelaide grant / Wages - please provide breakdown
Grants - other / Artist fees - please provide breakdown
Grants - other / Administration fees
Grants - other / Accounting / Audit fees
OTHER INCOME / Other
Applicants $ / HIRES
Applicants in-kind support * / Marquees
Other $ / Furniture
Other in-kind support * / Venue
Exhibition fees / Staging / sound equipment
Stall holder fees / Security
Performance fees / Other
Sales i.e. art works / other / MARKETING & PROMOTION
Membership subscriptions / Advertising - please provide breakdown
Other / Promotion - printed material
Other / Promotion - online / digital
Postage
Other
INSURANCES
Public Liability Insurance
Other
CITY OF ADELAIDE FEES
Development Approvals
Permits
Park Land fees
Venue hire
Waste
Road closure
Other
MISCELLANEOUS
Catering
Art materials - please provide breakdown
Other materials - please provide breakdown
Documentation
Other
Other in-kind support *
TOTAL INCOME / TOTAL EXPENDITURE

Please note -

a) In-kind support (income) also requires a corresponding expenditure item (see sections marked *)

c) Total income must equal total expenditure

Budget details
Please provide a detailed breakdown of relevant marketing and promotion budget items here and how these will assist your project

1.14 Who else is funding the project and what will their contribution be?

Type of Support / $ Value / Status (Confirmed/Pending)
City of Adelaide / Grant / Pending
Applicant / Financial
In-kind
Others ^ / Financial
In-kind
Total Amount

^ Others refers to funding partners and other sources of financial and/or in-kind support.

1.15 Could your project proceed if only partial funding was received? Yes No

Please provide details.

1.16 Has the City of Adelaide funded you / your organisation over the last two (2) years? Yes No

If yes please provide details below:

Date Funded / Amount / For What Purpose?
2016-2017
2015-2016

ASSESSMENT CRITERIA 2 - Strategic Plan Alignment

(35% of assessment)

Please indicate which of the City of Adelaide’s strategic actions your project addresses.

(Select multiple boxes if relevant and please ensure that details are provided to support your response)

Smart: A smart city with a globally connected and opportunity rich economy

Showcase the City’s unique heritage and character

Bring together the creative, arts, business, university, education and entrepreneurial sectors

Rejuvenate laneways and pedestrian connections

Please provide details on how your project will address the ‘Smart’ actions selected above

Green: One of the world’s first carbon neutral cities and an international leader in environmental change

Promote sustainable transport options, such as public transport, cycling and walking

Utilise low carbon or renewable energy sources

Promote environmental issues

Increase public and private greening with trees, gardens, green walls and roofs

Reuse and recycle equipment, consumables and materials

Reduce mains water use through utilising recycled and reused water

Please provide details on how your project will address the ‘Green’ actions selected above

Liveable: A beautiful, diverse city with an enviable lifestyle that is welcoming to people at all stages of life

Develop and celebrate strong and resilient City communities that are welcoming and encourage people of all ages, cultures and means to participate in City life, including through volunteer opportunities

Support vulnerable members of the community

Enable people to use the City safely and seek to reduce crime

Enhance the role of the Park Lands in increasing levels of physical activity and wellbeing through formal and informal sport and recreation opportunities

Please provide details on how your project will address the ‘Liveable’ actions selected above

Creative: A multicultural city with a passion to create authentic and internationally renowned experiences

Contribute to the development of Adelaide as the premier international arts market, especially within the Asian region

Increase opportunities for live music and performers

Increase the number and diversity of audiences and visitors at festivals and events

Support businesses, community groups and individuals to grow their contribution to the creative, cultural and artistic life of the City

Bring creativity and smart technology into the everyday experience of our City

Partner with cultural institutions to increase visitations in the City and Park Lands

Surprise, delight and attract people through dynamic and changing urban public spaces, heritage, art, laneways, streets, facilities and activities

Promote and showcase multiculturalism and Aboriginal culture

Please provide details on how your project will address the ‘Creative’ actions selected above

ASSESSMENT CRITERIA 3 – Cultural and Creative Value

(25% of assessment)

3.1 What experience do you / your organisation have in delivering similar projects to the one proposed in this application? Detailed CV’s / bios can be attached as support material at section 3.5.

3.2 Does your project involve collaborations with other creative and / or cultural practitioners?

Yes No

If yes please provide details, including information on any previous collaborations if relevant.

3.3 Does your project involve the creation of new artistic work or incorporate any new and / or innovative approaches? Yes No

If yes please provide details.

3.4 If your project has been held in previous years, will you be undertaking anything new / different as part of this proposal?

Yes No N/A (first time project has been held)

If yes please explain how this proposal differs from any previous iterations.
3.5 Support Material
Please provide up to 5 attachments to support your proposal.
These may include:
- CV’s / bios for key project personnel (max. 2 pages)
- images / portfolios of relevant creative practitioners’ work (max. 5 images)
- concept rationale / research / designs (max. 2 pages)
- site / installation plans
- URL links to vimeo, youtube or other websites
- letters of support (2 max.)
- reviews (3 max.)
- evidence of consultation with affected businesses / stakeholders
- any other relevant documentation
Please list below the support material attached to your application (5 documents maximum).
a)
b)
c)
d)
e)

APPLICANT CERTIFICATION

I certify to the best of my knowledge that the statements made in this application are true.

I have read the City of Adelaide’s 2017/2018 Arts and Cultural Grants Program Guidelines.

I understand that, should this application be approved by the City of Adelaide, I would be required to accept the conditions of the grant in accordance with the City of Adelaide’s accountability and reporting requirements.

Name of Applicant / Delegated Officer
Signature
Today’s date

An Auspice Organisation receives the grant on behalf of the applicant and is legally responsible for ensuring the project is delivered. If this grant is to be auspiced, please complete the following details for the Auspicing Organisation:

AUSPICING ORGANISATION

Name of Auspicing Organisation
Address
Phone
Email
ABN
GST status / Registered Not Registered
Name of Delegated Officer
Role of Delegated Officer
I certify that we are to be the auspicing organisation for this project
Signature
Today’s date

CHECKLIST

Please acknowledge the following checklist before submitting your application:

I have read the City of Adelaide’s Arts and Cultural Grants Program Guidelines

I have discussed my project with the Arts and Cultural grants officer prior to commencing my application: Malia Wearn / Phone: 8203 7807 / Email:

Public Liability Insurance

I am aware that should my application be successful, I will be required to provide a copy of my Public Liability Insurance “Certificate of Currency” (minimum $20million), or my auspicing organisations insurance, noting the City of Adelaide as an interested party

Return to Work SA / Employee Insurance (if paid staff are employed)

I am aware that should my application be successful, I will be required to provide a copy of my Return to Work SA certificate of registration or similar employee insurance policy

I have answered all questions in the application and signed the Applicant Certification

I have submitted two copies of my application by one of the following methods:

By post to -

Malia Wearn, Case Management Officer

City of Adelaide, GPO Box 2252, Adelaide SA 5001

In person to -

Malia Wearn, Case Management Officer

c/o Customer Service Centre, City of Adelaide, 25 Pirie Street, Adelaide SA 5000

Please note that late, faxed or emailed applications will not be accepted

I have kept an additional copy of my application for my future reference

ATTACHMENT A: HOW TO COMPLETE A PRELIMINARY RISK ASSESSMENT

The primary objectives of the Preliminary Risk Assessment are to:

• identify hazards associated with undertaking the work
• determine the level of risk
• establish the appropriate risk control measures
  

Each major or significant task or activity associated with the proposal shall be assessed in terms of the potential risk factors and the most likely outcome as a result of an incident.

Risks shall be classified according to the following schedule:

Class 1: potential to cause death or permanent injury to one or more people

Class 2: potential to cause one or more injuries requiring medical treatment; and

Class 3: potential to cause an injury treatable with first aid

The aim of the Preliminary Risk Assessment shall be to eliminate Class 1 and 2 risks associated with the proposal. Applicants should detail risk control measures which address all identified Class 1 and 2 risks. When determining risk control measures, the hierarchy of controls summarised below must be considered:

Eliminate the Hazardeg: offsite cutting of panel work

Substitute the Hazardeg: replace ladder with scissor lift, substitute solvent based paint with water based paint

Engineering Controlseg: reverse alarms/lights fitted to plant, exhaust ventilation to remove fumes

Administrative Controlseg: job rotation, work instructions, safety inspections

Personal Protectiveeg: hearing protective devices, respirators, equipment hard hats

When safe work procedures or instructions are developed they must:

• outline a work sequence
• highlight the procedures required to control the identified Class 1 and Class 2 risks
• inform all people involved in the activity about safe work procedure

The Preliminary Risk Assessment Form requires the applicant to:

1. Specify each Task/Activity associated with the proposal in the sequence in which it will be performed from the beginning to the end product/or its installation.
2. Name the Potential Hazards associated with each activity or task to be carried out.
3. Evaluate each Hazard as a level of risk, described as Risk Class 1, 2 or 3 defined above to prioritise the risk control measures.
4. Identify a Control Measure necessary to eliminate or minimise the hazards that may lead to accident, injury or occupational illness.

Hazard Identification and Control Table

The following table provides examples of control measures for a range of generic hazards. These examples are provided as a guide only and important site specific factors must also be considered. Note also that this table of examples does not include all possible hazards.

Hazard / Possible Cause / Control Measure
Traffic Hazards / Working in close proximity to roads / Installation of temporary traffic signals
Use of Safety Signs
Speed restriction signs displayed and enforced
Use of witches hats or temporary barriers to cordon off sections or whole of road
Manual Handling / Handling of heavy objects / Use of lifting aids
Imposed restrictions on certain activities
Contact with Heat / Hot materials
Fire in the Workplace
Exposure to sun / Provide appropriate protective clothing and training
Remove flammable materials or store correctly
Provide adequate firefighting equipment
Employee firefighting awareness
Provide protective clothing and sunscreen
Reduce exposure time
Contact with Electricity / Faulty electric leads and tools
No earth leakage detectors
Electric leads on ground
Electrical leads in damp areas
Electric leads tied to metal rails
Contact with underground or overhead cables / Tools and leads inspected and tagged
Residual current devices in all circuits and tested
Electrical leads kept elevated and clear of work areas
All electric leads kept dry
All electric leads are kept insulated
Location of services and overhead cables to be established
Services to be isolated when working in proximity
Establish safe clearance distances
Exposure to Noise / Not wearing appropriate noise protection / All personnel to wear appropriate personal protective equipment (hearing protectors)
Contact with dangerous substances (chemicals) / Incorrect handling procedures
Lack of information
Not wearing appropriate personal protective equipment
Incorrect storage
Elevated exposure levels / All personnel informed with regard to correct handling and product sheets as required
Staff provided with appropriate personal protective equipment
Hazardous substances stored and labelled correctly
Provide mechanical ventilation
Struck Against / Protruding objects in access routes
Not wearing appropriate personal protective equipment / Protruding objects are removed or marked
Provide appropriate personal protective equipment and training
Struck by Object / Objects falling from work platforms
Debris from grinding operations
Windblown particles
Loads slung from cranes / All work platforms fitted with toe-boards
Fence off areas below to prevent access
Materials stacked securely
All personnel wear appropriate personal protective equipment (hard hats)
Secure loose objects to structure
Loads not slung over personnel
Loads slung correctly
Fall from Height / No handrails
Working outside handrails
Floor penetrations not covered
Ladders not secured
Unsafe area / All work platforms have secure handrails
Persons wear full fall arrest type harness
All floor penetrations covered or barricaded
All ladders secured to prevent movement
Ladders to extend at least 1m above landings
Tag and fence to prevent access
Slips and Falls / Access routes obstructed by materials
Leads/hoses across access routes
Slippery surfaces
Safety footwear not appropriate
Poor visibility / All access routes kept clear of materials and debris
All leads kept clear of ground or covered
All access surfaces kept dry and in good condition
Personnel wear appropriate safety footwear
Provide adequate lighting

Using the Hazard Identification and Control Table, complete the Preliminary Risk Assessment Form provided and submit to the City of Adelaide as part of the application process.
See example below: