Community Grant Program
Individual Achievement Application Form

ELIGIBLE CRITERIA

The spirit of the grant program is to efficiently support applications that address a need of the Griffith Local Government Area. It is grant based in nature.

It is important thatthe Community Grant Program is linked to the recommendations of Growing Griffith 2030and applicants must demonstrate this in their written applications. The Growing Griffith 2030 Plan can be found at (Search 2030).

Applicants must meet the eligibility criteria to ensure adequate coverage against potential risk and ensure funds are being directed to appropriate organisations.

Applications shall be considered on their merit, taking into account the circumstances of each case, the availability of funds in Council's budget, the extent to which Council has previously provided funds, the provisions of this policy, and the relevant provisions of the Local Government Act 1993 (as amended).

Please refer to Griffith City Council’s Community Grant Policy FS-CP-601 for terms, conditions and eligibility. The Policy can be found at

INDIVIDUAL ACHIEVEMENT GRANT

APPLICATION FORM

This application form is intended for individuals who need support from the Griffith City Council Community Grants Program to attend significant events or activities at the Regional/State, National or International level.

All applicants must meet complete the form with all supporting information to be eligible. Assessment is based on merit. Applicants can only apply at the level for which they are representing.

1 / Name of Applicant / ______
2 / Contact Details
(of Guardian if under 18 years) / Guardian Name (if under 18 years) ______
Address: ______
______
Phone: ______
Email: ______
3 / Applicant Date of Birth / ______/______/______
4 / Activity/Event* / Title: ______
Name of Organisation or Association arranging the event:
______
Address: ______
______
Dates: ______to ______
Venue: ______
*Please attach a copy of the event flyer/invitation/support letter
6 / Study / School  TAFE  University  Other 
Not Studying  Fulltime  Part Time 
7 / Employment / Not Employed  Fulltime  Part Time 
8 / Support / Is the applicant financially dependent on parents/guardians?
Yes  No 
Does the applicant require the support of a carer?
Yes  No 
Please provide any other information to support your application for a Grant. (For Example: Financial hardship, if your family uses a health care card or is a beneficiary of other Government benefits______
______
9 / Financial support requested in this application / Regional/State ($500) National ($750)  International ($1000)
Are you be able to attend without receipt of this financial assistance
Yes  No 
10 / Budget / Other Income: (if relevant to this application)
Fundraising/Sponsorship/ Other grants:$______
Has the applicant previously applied for a Grant from Griffith City Council?
Yes  No 
Proposed Expenses
Accommodation$
Airfare/Travel/Fuel$
Costume/Uniform$
Registration$ ______
Equipment/Materials$ ______Please specify below: ______
Other: ______
Total: $______

Eligibility and selection criteria

  • All applicants need to have resided within the Local Government Area of Griffith for at least the past two (2) years.
  • Supporting evidence and approximate budget must be provided and balance.
  • The full amount of funds requested, may not necessarily be granted.
  • Individuals are only eligible to apply once per financial year.
  • The acquittal form must be completed within one (1) month of returning from the activity/event.
  • Please ensure you produce evidence and receipts of expenses.

Documentation checklist

Provide documents from the following list:

 Letter from applicant team/association/group/teacher/trainer

 Letter or invitation from the event organiser regarding applicant attendance

I, ______agree that I have read and will abide by the Conditions of the Community Grants Program – Individual Achievement.

 I have been a resident of the Local Government Area of Griffith for at least two years

Signature of Applicant:

Signature of Parent/Guardian:_____

(if applicant is under 18 years)

Guardian Name: ______

Application forms must be returned to:

ATT: Community Grants Program

Griffith City Council

PO BOX 485

Griffith NSW 2680

Please ensure that your application is submitted well before undertaking any of the proposed activity/event/project.

For more information contact Community Development Team

02 6962 8100

Privacy Notification

The personal information provided by you in this application is required for the sole purpose of processing your application for funding assistance under the Community Grants Program and will be protected in accordance with the provisions of the Information Privacy Act 2000 and Council’s Privacy Policy. The information will be disclosed to Councillors, the Councils Section 355 Communities Committee and to Council Officers. All applications will be securely disposed of when the application is finalised. If you choose not to provide the information that is sought your application may not be processed.

Community Grant Program Application / 1