APPLICATION FORM FOR
GIRL GUIDES AUSTRALIA SPECIAL PURPOSE FUND

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PERSONAL DETAILS OF APPLICANT

Preferred Title: / Given Names: / Family Name:
Address: / Email:
State: / Postcode:
Phone (BH): / ( ) / Mobile: / ( )
Phone (AH): / ( ) / Fax: / ( )
Membership No: / Expiry: / /
Current Positions in Guiding:
Age: □ 13-18□ 18-20□ 21-25□ 26-30 □ 31-35 □ 36-45 □ 46-55 □ 56+
Individual application □Group application (personal details of group coordinator to be included above) □

Explanatory Notes

  1. Before applying, please consider these priorities for the Girl Guides Australia Special Purpose Funds:
    - support members between the ages of 13 and 35 years to attend a State, national or international event,
    - support members to attend events organised by the World Association of Girl Guides and Girl Scouts, Member Organisations, Girl Guides Australia, government and non-government organisations (examples of appropriate events include United Nations events, WAGGGS events, Juliette Low Seminars, Helen Storrow Seminars, Asia Pacific Region events, national and international camps, conferences and trainings for trainers and leaders),
    - support selected projects related to people rather than buildings, which will be for the long term benefit of the Girl Guide Movement, both in Australia and throughout the world (examples of appropriate projects include trainer from overseas, training resource, international service, community service, advocacy, research, and pilot projects), longer term projects may have funding allocated for up to two financial years.
  2. Endorsement should be provided by the Chief Commissioner, State Commissioner or another appropriate person such as an office-bearer. An application for assistance for an event or project within a State is expected to include endorsement at State level. A national or international event or project will require the endorsement of the Chief Commissioner or the relevant Manager.
  3. All recipients of funding are expected to conduct at least one fund-raising activity for theGirl Guides Australia Special Purpose Funds to ensure continued benefits for all in Guiding; provide a presentation about the event or project for others (in person or through other media); and submit a report to the Special Purpose Funds Executive Committee within three months of completion of the event or project.

Please complete reverse side of this form

DESCRIPTION OF EVENT OR PROJECT (to be completed by the applicant)

Title of event or project:
Description of event or project (including implementation and timeline) - attach additional page if necessary:
Expected outcomes, including benefits to the participant(s) and Guiding in general:
Estimated cost of the event or project(event – airfare and/or event fee, project – attach budget):
Event: Event Fee $ . Airfare $ . Project: $
Amount requested from the GGA Special Purpose Funds: $
Other qualifications, interests, experiences or comments relevant to the event or project:

SUPPORTER’S ENDORSEMENT—see Explanatory Notes

RelevantBusiness or Strategic Plans for Girl Guides Australia or the World Association of Girl Guides and Girl Scouts:
Comments:
Name: / Signature: / Date: / /
Phone (BH): / ( ) / Email:
Phone (AH): / ( ) / Position in Guiding:
Signature of Applicant: / Date: / /

Completed form to be forwarded to:
Special Purpose Funds Executive Committee, National Office, Girl Guides Australia.

Office use only:

Application approved: Yes □ No □ / Applicant and relevant office-bearers notified in writing: Yes □ No □
Funding amount: / Relevant office-bearer:
Conditions:

GGA.SPFunds_Application Form_v1.16112015

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