International Student Wellbeing Grant Form

International student wellbeing grant form

This application form is for the International Student Wellbeing Grant – up to $10 000.

Grants are open, but not limited to student and community groups, associations, businesses and not-for-profit organisations to deliver activities or events that enhance the wellbeing of international students and encourage them to experience life as a Territorian. Applicants working in collaboration are strongly encouraged.

Applications for this grant round close midnight ACST Sunday 14 January 2018.

International wellbeing grant form /
Applicant details
Name of applicant / organisation / business
Contact Person
Position Title
Contact Number
Email Address
Postal Address
Suburb / State / Territory / Post Code
Activity / event details
Name of activity / event
Location of activity / event
Date(s) of activity / event
Organisation details (75-100 words)
Please provide a brief description of your organisation
Is your organisation registered for GST? / Yes / No
Are you an Income Tax Exempt Body?
If yes, please attach a copy of tax exempt endorsement / Yes / No
What is your Australian Business Number?
Incorporation Number (for incorporated associations)
Grant information
Have you applied for / or received funding from another source for the activity you are applying for? / Yes / No
If yes, please specify the funding source and the amount applied for and / or received.
Provide a detailed description of the event / activity. (150-200 words)
How will the activity meet the objectives of the grant program?
What do you / your organisation want to achieve from this activity? (40-60 words)
How many international students are you targeting?
What kind of commitment will your organisation give this activity?
Financial
Planning
Staff / Volunteer
Insurance
Use of Facilities
Other
Please select how you will promote the Northern Territory Government’s funding?
Recognition of the grant is a condition of the funding.
Media Advertising / Posters
Website / Printed materials
Banner / Social media
Other (please specify)
How did you find out about the International Student Wellbeing Grants?
Facebook Ad / Social Media
Email / StudyNT website
nt.gov.au website / Word of mouth
NT News / Other (please specify)
Funding information
Please detail what you will be spending the grant funding on. Please check the guidelines for details of what is eligible for funding and what is not.
Item / Amount
Wages / Fees
Catering
Hire of Venue
Hire of Equipment
Consumables
(e.g. printing, office supplies)
Equipment purchases
Travel
Airfares
Accommodation
Other (please specify)
Total funding amount requested
Authorisation and privacy notice
I certify, as an authorised representative of the applicant that the information provided in this application is true and correct (applicants under the age of 18 years must obtain the signature from their parent / guardian).
I acknowledge and agree that information about my event and in this application form may be publicly released for the purpose of promoting and reporting the event.
I agree to information about my event and in this application being distributed via promotional materials developed, through Government websites, annual reports and media releases issued by the Northern Territory Government.
Signature / Date
Printed Name
Position Held
Organisation
Auspice Organisation Name (if required)
Auspice Organisation Signature (if required) / Date

Submitting your application

Applications should be emailed to .

For more information visit www.studynt.nt.gov.au or contact StudyNT by emailing or calling 89996316.

Department of Trade, Business and Innovation Page 2 of 4

November 2017