Salisbury Communities for Children

Salisbury Communities for Children

Application for Funding for activity

3.3.1 “Autism Spectrum Disorder (ASD) support for families”

2015/17

Applications to:

Karl Brettig

Manager Salisbury Communities for Children

PO Box 144, Para Hills 5096

Ph. 8397 9333

Applications should be received no later than 29th June

Activity details

Activity name:3.3.1 ASD support for families

Funding Allocation: $34, 000 pa

Contract Period:01 July 2015 to 30 June 2017

Organisational details

Organisation
Postal Address
Date of incorporation
Contact Person Details
Title, first and last names
Position in organisation
Phone number
Fax number
Email address
Is your organisation registered for GST?

Selection criteria

All questions provide an indication of an organisation's readiness and any additional supports that the facilitating partner can/may be able to provide.

What experience does your organisation have delivering services in Salisbury, and with children with ASD or other disabilities and their families?(Must be no more than 300 words)

Discuss the early intervention and prevention approaches that underpin your organisations engagement with children and families, and with reference to children with ASD or other disabilities and their families. (Must be no more than 300 words)

What strategies does your organisation use to encourage access and engagement by children and families from (some or all of) the following target groups:

•from CALD backgrounds

•fathers

•Aboriginal families

•Young parents (<25years)

•Children with a disability

•Families experiencing disadvantage(Must be no more than 300 words)

Describe your organisations child safe practices/policies.(Must be no more than 50 words)

Who will you collaborate with to deliver the program or activity? Are there volunteers involved? (Must be no more than 300 words)

Is there any in kind or other funding contributing to the project? (Must be no more than 200 words)

Budget details

Please provide an estimate of how the $34 000 pa will be spent

Proposed budget
Budget line / Description / Proposed budget / In-kind
Staff
Staff salaries (salary level and hours)
On costs
Management/coordination
Staff training
Resources
Administration
Insurance
Accounting and auditing
Venue costs
Rent
Utilities
Stationary
Program costs
Catering
Promotion
Resources
Other…
Transport costs
Travel
Phone and ITC
Telephone
Mobile phone
Internet
Computer
Total

Attachments

Attachments necessary for this application:

•Public liability insurance certificate

•Copy of Certificate of Incorporation or a copy of your organisation's constitution (whichever is applicable)

THE FOLLOWING DECLARATION MUST BE SIGNED BEFORE SUBMITTING YOUR APPLICATION

DECLARATION BY APPLICANT ORGANISATION

We, the persons making this application, declare that;
1.the information contained in this application is true and correct in every detail;
2.we have been authorised by the applicant organisation to prepare and submit this expression of interest.
We undertake, should our organisation be successful in its expression of interest to carry out an Activity under the Communities for Children –Salisbury Project to:
1.enter into a Contract with The Salvation Army –Ingle Farm;
2.seek, in writing, approval from The Salvation Army –Ingle Farm for any alterations to the approved activity;
3.expend the grant monies within the period stipulated within the contract;
4.return to The Salvation Army –Ingle Farm any portion of the grant monies that were not acquitted appropriately under the contract for which the grant was provided;
5.acknowledge the Department of Social Security and the Communities for Children Project according to the guidelines for promotion issued by the Department and included within the Contract.
6.acquit the grant in accordance with the requirements of the Department by completing: 1. Data Collection as required by the DSS Data Exchange 2. Evaluation Reports 3. Providing receipts for each quarterly payment 4. Having annual financial statements audited by a certified auditor.
President/Chairperson/CEO/Director (Responsible Officer)
Signature: ______
Name:
Position:
Date:
Treasurer/Secretary
Signature: ______
Name:
Position:
Date:

Applications should be received no later than 29th Juneand addressed to;

Jacquie Dell

Assistant to the Director

The Salvation Army Ingle Farm

PO Box 144, Para Hills 5096

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