Show Societies Resilience Development Fund 2013-14 Application Form

Show Societies Resilience Development Fund 2013-14

Application form

Applications close on 16 August 2013

Applicant details

1. Applicant organisation

1. List of Show Societies represented in application (refer Appendix 1)

1. Principal contact person This person will be contacted about the application

Title: / Organisation
Position: / Given name:
Phone: / Surname:
Email: / Mobile:

Project overview

1. Which best describes the proposed project?

Disaster management and resilience plan Professional fees
Software/databases Other please detail
Other show related asset

1. Project title and description

Project Details

1. How will this project support the applicant’s preparednessfor a natural disaster event?(Approximately 250 words)

1. How will this project assist in building the community’s capacity to support the conduct of an annual showin communities impacted by a natural disaster event?(Approximately 250 words)

Project Budget

Total project cost (GST exclusive) / A / $
Total funding requested (GST exclusive) / B / $
Breakdown of total project costs (e.g. professional fees, capital assets)
$
$
$
$
$
$
$
Applicant’s own source contributions / C / $

Certification

I certify that:

·I am authorised by the applicant organisation/sto submit this application for funding

·all participating show societies support this application (in the case of an application on behalf of a group of show societies)

·I endorse this application for funding

·the details in this application are true and correct

·participating show societies will deliver the project within the required timeframe

·the project will comply with all relevant Acts, Laws, Regulations, Queensland or Commonwealth policies and Industrial Agreements and Awards

·the ongoing operation, maintenance, management and replacement costs for the project will be met by show societies

·show societies consent to the release of information in this application (excluding personal details) for non-commercial public information purposes

·should this application be successful, I confirm that the project will not commence until after funding has been approved and a funding agreement has been executed with the department.

To be signed by either;

1. President of the applicant organisation
2. Director/Delegate of a sub chamber – on behalf of a group of show societies
3. Chief Executive Officer, QCAS – on behalf of group of show societies

Given name / Surname
Position / Organisation
SignatureDate:______/ ______/ 2013

Scan signed page and email application form to: by the 16 August 2013

APPENDIX 1

QCAS Sub-Chambers and Member Show Societies

BURNETT (10)

/ DARLING DOWNS (19) /

SOUTH BURNETT (7)

Biggenden / Allora / Blackbutt
Bundaberg / Bell / Goomeri
Eidsvold / Clifton / Kingaroy (South Burnett)
Gayndah / Cooyar / Murgon
Gin Gin / Crow’s Nest / Nanango
Isis District (Childers) / Dalby / Proston
Monto / Goombungee-Haden / Wondai
Mt Perry / Goondiwindi /

SOUTH EAST Q’LAND (9)

Mundubbera / Inglewood
Tee Bar / Jandowae / Beaudesert
CENTRAL HIGHLANDS (6) / Killarney / Beenleigh
Millmerran / Brookfield
Alpha / Oakey / Canungra
Capella / Pittsworth / Gold Coast
Clermont / Stanthorpe / Mt Gravatt
CometRiver / Tara / Mudgeeraba
Emerald / Texas / Rocklea
Springsure / Toowoomba / TambourineMountain
Warwick
CENTRAL QUEENSLAND (15) /

NEAR NORTHCOAST (15)

/ SOUTH WEST Q’LAND (12)
Baralaba / Caboolture / Charleville
CallideValley (Biloela) / Dayboro / Chinchilla
Gladstone / Eumundi / Cunnamulla
Mackay / FraserCoast (Maryborough) / Dirranbandi
Marlborough / Gympie / Miles
Mt Larcom / Kenilworth / Mitchell
Mt Morgan / Kilcoy / Quilpie
PioneerValley (Finch Hatton) / Maleny / Roma
Ridgelands / MaryValley (Imbil) / St George
Rockhampton / Nambour (SunshineCoast) / Taroom
Sarina / Noosa / Wallumbilla
The Caves / Pine Rivers / Wandoan
Theodore / Redcliffe
Wowan / Samford
Yeppoon / Woodford
CENTRAL & NTH WEST (10) / NORTH QUEENSLAND (14) / WEST MORETON & BNE VLY (10)
Barcaldine / Atherton / Boonah
Blackall (Barcoo) / Ayr / Esk
Cloncurry / Bowen / Gatton
Hughenden / Cairns / Ipswich
Isisford / ChartersTowers (Towers) / Kalbar
Longreach / Cooktown / Laidley
MountIsa / Giru / Lowood
Muttaburra (Landsborough) / Ingham (HerbertRiver) / Marburg
Tambo / Innisfail / Rosewood
Winton / Malanda / Toogoolawah
Mareeba
Mossman / Other (1)
Proserpine / Royal Queensland Show (Ekka)
Tully

Show Societies Resilience Development Fund 2013-14 1