Community Fund Application Form

Community Fund Application Form

This document is to be completed in line with the insuructions provided in the Tarong Community Partnership Fund Application Guide.

Applicant details

Registered name (organisation): Click here to enter text.

Registered address:Click here to enter text.

Postal address: Click here to enter text.

Authorised Contact: Click here to enter text.

Position: Click here to enter text.

Telephone: Click here to enter text.

Mobile: Click here to enter text.

Email: Click here to enter text.

If your organisation will not directly invoice for this project, please provide details of the invoicing organisation below.

Registered name: Click here to enter text.

Address: Click here to enter text.

Contact person: Click here to enter text.

Organisation overview

Please describe your organisation and provide examples of other projects it has delivered.

Community connections

Please list other organisations involved in the project, or any other community organisations that will benefit from your proposed project.
For example: If your project proposes building upgrades, do other community organisations utilise the facilities?

Project overview

a)  Project title: Click here to enter text.

b)  Project description – please provide an overview of what your project will achieve & how it aligns with the eligibility criteria outlined in the application guide.

Project funding & attachments

a)  The total cost of the project: $Click here to enter text.

b)  The amount requested from the Tarong Community Partnership Fund: $Click here to enter text.

c)  Other funding applied for/secured

Funding Body / Amount Sought / Amount Received / Funding Conditions (if any)

Please ensure you have attached the following documents:

ð  Project budget

ð  Quotes

ð  Building approvals (if applicable)

Examples of a project budget are available on the Stanwell website; you can find it off the Stanwell home page under Our Communities > Supporting our communities > Budget or simply click here

Declaration

I declare that the information in and with this application form is correct, and that I am duly authorised to make this application and this declaration.

Signature: Click here to enter text.

Name: Click here to enter text.

Date: Click here to enter a date.

Please email application, together with requested attachments to: