Perth Banksia Woodland Community Restoration Grants
1 June 2014 – 30 September 2016
Application Form
PROJECT TITLE
APPLICANT DETAILS
Group namePostal address
Project contact person
Position in organisation
Telephone
Email / Mobile
Bank account name
Bank account number / BSB
Is your group incorporated? / yes / no
Is your group registered for GST? / yes / no
Does your group have an ABN (Australian Business Number)? / yes / ABN:
no / complete Statement by Supplier form see page 9
If your group is not registered for GST you may wish to partner with another organisation with GST registration to avoid loss of the GST component. You may remain the project contact person but the organisation registered for GST will be listed as the applicant and responsible for financial accounting and project acquittal.
If your group does not have an ABN you will need to fill in a Statement by Supplier form (see page9). Your group is regarded as the ‘supplier’ as you are providing the Department of Parks and Wildlifewith a service/supplying labour.
If successful, please be advised that the Department of Parks and Wildlife will raise an invoice on your behalf and funds will be dispersed into your nominated bank account.
$GRANT SOUGHTTotal amount (excluding GST):
minimum $5,000 maximum $20,000
Provide a break-down of funds sought from Department of Parks and Wildlife into funding instalment periods
June 2014-September 2015 / October 2015-September 2016Contractors / $ / $
Materials / $ / $
Equipment hire / $ / $
Administration / $ / $
Other / $ / $
Specify contract services:
Specify materials:
Specify other:
CONTRIBUTIONS FROM YOUR GROUP OR PARTNERS
Who / Activity / June 2014-Sept 2015 / Oct 2015-Sept 2016In-kind labour (hrs) / hrs / hrs
Financial / $ / $
PROJECT DESCRIPTION
What is the management or restoration issue?
What activities will be done?
Who will do the work?
When will the work be done?
Whatoutcomes for biodiversity will result from the work?
SITE DESCRIPTION
Who is the land management authority for the project site?
Letter of support from the land manager is attached.
What is the tenure of the project site e.g. nature reserve, local government reserve, other or a mixture?
Describe and detail any special conservation significance of the project area. Is it a Bush Forever site, locally significant bushland, contain threatened flora, fauna or ecological communities?
Describe the plant communities and the vegetation condition of the project area.
a map or aerial photograph of the project area is attached.
Please include the size, shape and linkage of the banksia woodland with other bushland or wetland areas and clearly show the boundaries of the project area.
GROUP HISTORY
Briefly describe the biodiversity outcomes your group has helped to achieve previously. Provide examples of your capacity for and commitment to urban bushland conservation
REVEGETATION PROJECTS
Please provide a list of any species to be used in revegetation and their source. Applicants are encouraged to contact theConservation Officer, Swan Region to check for the availability of local provenance seed.
Species / Source e.g. seed collected from site, name of nursery, Parks and Wildlife supplied seed1 of 9
MONITORING AND EVALUATION PLAN
Applications will be assessed on their ability to set-up an effective monitoring system to gauge biodiversity outcomes of the work. Applicants are encouraged to contact the Bushland Community Coordinator for assistance in developing their monitoring plan.
Rehabilitation objectivee.g. 1) establishment of 2 ha of banksia woodland revegetation
e.g. 2) effective control of weed species XX / Measure
e.g. 1) seedling mortality
e.g. 2)cover & distribution of weed species XX / Method
e.g.1) seedling survival counts/species in 5 10x10m plots & establish photopoints
e.g.2) map distribution of weed species XXprior to treatment and after two annual treatments / Who
e.g. 1) Friends group
e.g.2)Friends group and Department of Parks and Wildlife / Time-frame
e.g. 1) first count/photo after planting and annually in autumn for 2 years
e.g.2)Prior to herbicide treatment (winter 2014) and after 3 sprays (winter 2016)
The proposed monitoring plan will extend beyond30 September 2016. I agree to undertake the monitoring plan and supply the final report to Department of Parks and Wildlife upon completion. An interim monitoring report will be supplied 30 September 2016.
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CHECKLIST FOR APPLICANTS
Please use the following checklist to ensure that you have completed and supplied all of the relevant information supporting your project application.
Supplied your ABN (if relevant)
Supplied your Statement by Supplier form (if you do not have an ABN)
Supplied your bank account details
Calculated the budget excluding GST
Attached a letter of support from the land manager
Attached a letter of support from any project partners
Attached a map or aerial photo of the project site and adjacent bushland
Completed the monitoring plan
Signed the application
CONTACTS
General Information and Monitoring Plan Development: Julia Cullity, Community Bushland Coordinator or
Local Provenance Seed Availability: Anna Wisolith, Conservation Officer
DECLARATION
If this application is successful, my organisation agrees to use the grant for the purposes specified in the application, to maintain a separate record of the financial administration of the grant, and to acknowledge State Government support through the Perth Banksia Woodland Community Restoration Grants in any publicity related to a funded, or partly funded, project.
I agree to acquit the project on or before 30 September 2016.
My organisation will provide an interim report by 30 September 2015 and a final report comprising project summary, monitoring data and financial statement at the completion of the project and return any unspent funds with the final report to Department of Parks and Wildlife.
Signed: …………………………………………………….Date ……………………
Name (please print): ……………………………………..
If submitting the form electronically, please type name here
Applications Close at 5.00pm Monday 14 April 2014
late applications will not be accepted
Please email applications (<10 MB including all attachments) to
Fax applications to 9386 6399
Or post to Perth Banksia Woodland Community Restoration Grants
Department of Parks and Wildlife
Swan Region
Locked Bag 104
Bentley Delivery Centre, Bentley 6983
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