Mountain Bike Fund Application Form

Round 5: September 2017

Instructions

  • This application form is to be used by those wishing to apply to the Mountain Bike Fund administered by Trail Fund NZ
  • Refer to the “Guidelines for Applicants”for the applicable fund before completing this application
  • Type on the grey boxes to supply information.
  • If you do not know who your local DOC contact person is or are having trouble finding the right person, please contact Richard Davies (027) 7028865

Applications must be emailedbythe 30th of September 2017to Nessa Lynch at

Section A: Details of your project
Project Name:
Project Location:
Section B: Applicant Details
Full legal name of organisation: / Postal Address:
Name of person submitting this application:
Email Address: / Mobile:
Landline:
Website (and / or Facebook Page): / Local DOC contact person
Section C: The Project
Please describe your project and why it should be funded in less than 250 words (You are welcome to include as attachments any drawings, photos or other media that assist in informing us of your project)
Intended Uses and User Groups:
How will this increase use of the area?
Do you have an idea of outputs that will result from the proposed work?
E. g Km track maintained? Other?
Is this a new project? yes no
Comments:
Will the project have any negative impact of the natural environment, other recreation groups or on the historic character of facilities? yes no
Please explain
Current project status (click to select) Planning Stage Ready to start
How will the project be maintained in the future?
Section D: What you are applying for
What is the total cost of your project (GST inclusive)?
How much are you applying for from the Fund (GST inclusive)? Please examine the guidelines carefully in relation to matching funds. You may only apply for 75% of the project cost.
Describe how the other 25% of the costs will be covered, attaching documentation where possible.
Examples of matching funds may include cash held by the Club, a scheduled fundraising event, a discounted rate on materials or services, donation of materials/services.
What will the funds be spent on? (Attach more detailed budget if necessary, explaining key milestones and dates). Remember to include at least one quote for any material or services.
Section E: Checklist (Your application cannot be considered unless these documents are included)
-Confirmation that you have permission from DOC as the land manager –an email, or copy of the approval letter or maintenance agreement from DOC is sufficient.
-At least one quotation for the materials or services (We may ask for another quote or have the quote peer reviewed)
-Photos, maps or concept plans if available?
Section F: Declaration: By completing and submitting this application, you certify and understand that:
  1. The applicant group has read and understood the guidelines;
  2. The project is believed to be consistent with the eligibility requirements;
  3. All information provided is up to date, true and correct;
  4. The evaluation of applications has a subjective element and that the New Zealand Outdoor Recreation Consortium is the final decision-making authority;
  5. Information about the application (incl. applicant name, project title, and a summary of the proposal) and any approved funding may be made publicly available by New Zealand Outdoor Recreation Consortium;
  6. If a project proposal is approved, any grant of money is subject to a contract being entered into between the applicant and New Zealand Outdoor Recreation Consortium, including the requirement to acknowledge New Zealand Outdoor Recreation Consortium as a source of funding in signage, publicity and publications;
  7. It is a requirement that the applicant group report back on the success of their project;
  8. Before any work can commence, the applicant group will need to a) have an agreement with DOC that the work can be undertaken; b) undertake work to appropriate NZ or DOC standards; and c) ensure that health and safety is a priority,andwork with DOC to develop a plan, taking all practical steps to meet health and safety requirements;
  9. The signatory has the authority to commit the applicant to this application.
Duly authorized agent:
Name: Position:
Signature: Date:

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