Small Grants Program for Local History and Archives 2016

Application form.

Applicant

I am an individual (or) yes no

A community group yes no

Is the group affiliated with the RAHS? yes no

Applicant Name

Organisation (ABN registered name and number)

Mailing address

Is the organisation GST registered? yes no

How do we contact your organisation?

Name

Position

Mailing address

State Postcode

Phone Fax

Mobile

Email

Tell us about your project

Eligibility criteria:

Project Eligibility: Is this project-

Researching and presenting a local history ? yes no

A local archives collection management plan? yes no

A local digital image or photographic collection management plan? yes no

Other (please explain)

Small Grants Program for Local History and Archives 2016

Application form.

Tell us about your project (continued)

Project Title

Describe your project

How does your project meet the eligibility criteria? ( as marked in previous question)

Small Grants Program for Local History and Archives 2016

Application form.

How does your project meet the heritage grants criteria?

Will your project make a lasting historical contribution to an enduring future management

of heritage? Ie registration of a website with Pandora or preservation copy in local library (50 words)

How will your project increase opportunites for people to learn about, access and participate in

heritage? Eg use of volunteers(50 words)

Copyright and consent

Are you or your society the owner of the heritage item pertaining to this grant?

yes no

If no, please supply the name and contact details of the owner or attach a copyright consent form ( this can be found under the heritage grant documents on the RAHS website)

Small Grants Program for Local History and Archives 2016

Application form.

Timeframe

When did the project start? Month Year

Or, when is the project due to start? Month Year

What steps have been undertaken?

Approximate date you expect the project to be completed? Month Year

Estimated project expenditure (budget)

What are the estimated material and labour costs that will be incurred by your project? Please include the estimated value of work performed (paid and unpaid) and list the roles, hours, and hourly rate value for both paid and volunteer workers.

Example:

Researcher for heritage project / 20 hours @ $30 hour= $600 / Need to research background
Archival materials / $ 150 / Sleeves and binders for storing
Item / Cost / Description

TOTAL PROJECT VALUE $

Small Grants Program for Local History and Archives 2016

Application form.

Sources of Funding

Please describe what funding is available for the project?

Please describe any other grant or donations that have been secured in relation to this project?

Please describe any grants you have applied for in relation to this project?

WHAT AMOUNT OF FUNDING ARE YOU REQUESTING?

If this project is only partially funded, what elements are the main priorities for your project?

Supporting Attachments

Please check the boxes and attach material that is relevant to your project:

Budget A comprehensive budget for the project in spreadsheet form

Images Photographs, including full source details

Quotations for work Quotes for purchases and services necessary to the project

Outline Outline of sources you have already searched or plan to

Letter &/or CV’s Evidence that you have liased with professionals for the project

Sample chapter A sample chapter of your work ( if relevant)

Copyright consent form ( see RAHS website under heritage grant forms)

Small Grants Program for Local History and Archives 2016

Application form.

Supporting Attachments

Please attach to your application any agreements or describe formal arrangements that have been made between the sponsoring organisation and any auspicing body (individual, council, university etc)

Applicants declaration

The following signed declaration must include signatures of two office bearers of your society

or group. If you are an individual, please just include your signature.

This page must be signed to ensure your aspplication is valid.

Name

Position held

Signature Date

Name

Position held

Signature Date

1