Clermont Aboriginal Community Development Fund (ACDF)
Sport Sponsorship Application Form
Approval Date / Approved by / SignatureJacqueline Broderick
Karen Johnson
Mayleah Bemrose
Morne VanZyl
Petulia Stokes
Sarel Grobler
Revision Date / Revision Reason / Approved by
February 2016 / Updated draft version post AIG meeting pending approval by the ACDFC / Jean Bursle, Independent Person – for use for Q1 applications only pending approval
Background
The Aboriginal Community Development Fund (ACDF) has been established to provide funds to support a range of community projects that deliver positive, constructive, real and sustainable outcomes to the Aboriginal Community of Interest. The ACDF is administered by the Aboriginal Community Development Fund Committee (ACDFC) who meets on a quarterly basis.
Before completing this form, it is recommended that you read the Fund Guidelines which clearly outlines priorities for funding proposals and the matters the ACDFC will consider when making decisions on your application and that you take this into account in drafting your application. The Fund Guidelines may be found at
Decisions of the ACDFC are final and reasons are not given.
Funding may be provided for projects that will assist to achieve the ACDF “Vision for the Future”. “Sporting and community activities” is one of several types of projects that the ACDF may provide funding for.
The Sporting Sponsorship Application is designed to assist applicants to provide relevant information for sporting activities. If you have a community activity you wish to seek funding for, it may be more appropriate to use the general application form. Completely an application does not indicate that the ACDFC will provide funding for these activities in any particular funding round or at all. Prior successful or unsuccessful applications may not indicate the success of future applications.
The Guidelines indicate that the following types of applications may be considered:
- Specific grants to individuals whose specific circumstances require support.
- Assistance by way of scholarships for outstanding young sportspeople.
- Sponsorship of Aboriginal role models who will promote sport and sporting achievement.
It is important that applicants also address the mandatory criteria and any additional criteria that they would like the ACDFC to consider when submitting their application. From time to time the ACDFC may also develop specific guidelines in relation to sporting activities.
Eligibility
An application for funding from the ACDF may be made to the ACDFC by any member of the Aboriginal Community of Interest or an entity that proposes a project specifically for the benefit of the Aboriginal Community of Interest.
The Aboriginal Community of Interest is comprised of every person who is either:
a)A member of the Wangan & Jagalingou Native Title Claim Group; or
b)Able to provide evidence that he or she is an Aboriginal person who has resided within the area of the Wangan & Jagalingou Native Title Claim for more than one year.
How to apply
Each application for funding should:
a)Be made in accordance with the Education Scholarship Application Form that is available from the Executive Officer;
b)Application forms may be emailed or posted to:
Executive Officer
Clermont Aboriginal Community Development Fund
PO Box 491
Clermont Queensland 4721
Email:
c)Address the mandatory criteria and endeavour to address any applicable optional criteria listed in the Funding Guidelines
d)Be received by the Executive Officer at least 3 weeks prior to the nextACDFC meeting. Please contact the Executive Officer for details. Late applications are not required tobe consideredand in the ordinary course, will be deferred to the next ACDFC meeting. Meetings are generally held quarterly.
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1.APPLICANT DETAILSApplicant/ Guardian name:
Applicant/ Guardian postal address:
Applicant/ Guardian phone / mobile No.:
Applicant/ Guardian email address:
Are you a member of the Wangan & Jagalingou Traditional Owner group? / Yes / No (please circle)
If yes, which apical ancestor do you identify with?
If no, please provide evidence proving association with/to the Aboriginal Community of Interest.
Are you a member of any other Native Title Claim Groups? / Yes / No (please circle)
If yes, which other groups do you identify with?
2.PREVIOUS ACDF FUNDING
Have you (the applicant) previously applied for ACDF funding in Queensland? Please list your projects below? (Please note we may consult with other Funds/Trust).
Fund name: (e.g. Clermont ACDF) / Date / Project name / Amount funded
3.OTHER FUNDING
Have you made an application for Sponsorship/ Support for any other source for this project / activity? Include Government funding, non-Government support and corporate support both monetary and other support. Yes / No (please circle)
Do you intend to make an application foror seek Sponsorship/ Support for any other source for this project / activity?
Yes / No (please circle)
If yes, please provide details below:
Application made to: / Date / Amount requested or planned to be requested: / Amount of funding approved:
4.SPORTSPERSON’S DETAILS
Sportsperson’s name:
Sportsperson’s sport and team:
Sportsperson’s Postal address:
Sportsperson’s Phone/ mobile No.:
Sportsperson’s Email address:
5.SPORTING SPONSORSHIP DESCRIPTION
Please provide information on what the Sporting Sponsorship is for (e.g. individual selected for state representation for netball). Please make sure you address whether your application is one of the following types and why:
- Specific grants to individuals whose specific circumstances require support.
- Assistance by way of scholarships for outstanding young sportspeople.
- Sponsorship of Aboriginal role models who will promote sport and sporting achievement.
6.MAKING A DIFFERENCE
Please provide information on how this Sporting Sponsorship will make a difference. When you do this, please read the mandatory criteria in the Guidelines. Your answer must try to address those criteria. Your answer can also talk about the additional criteria in the Guidelines.
7. TASKS (What steps do you need to take to participate in this sporting event?).
TASKS / START DATE / END DATE
8.FINANCIAL INFORMATION (Please detail the costs of assistance sought. If you require goods or services, please provide two quotes or if you must obtain the good or service from one source and can only provide one quote, explain why this is).
Item / Details / Cost
$
$
$
$
$
$
$
$
$
Total assistance being asked for: / $
9.YOUR CONTRIBUTION
Please provide information on your or your family’s contribution. What is your financial contribution and outline any fundraising activities you will be organising or participating in.
10.DECLARATION
I declare the information contained in this application is true and correct, and I am not receiving any other funding from any other party.
If approved, I understand that my project will be subject to a formal agreement based on the information within this application. I understand that I must comply with the following conditions.
- to inform the ACDF immediately if the project is delayed or ceases
- to provide progress reports on activities and timeframes
- to provide an end of project report
- to participate in promotional activities and media opportunities identified by the ACDFC
I consent the disclosure of information from my project in the Annual Summary Report which is provided to the Wangan & Jagalingou Applicants, the Agreement Implementation Group, the Aboriginal Community Development Fund Committee and the Proponent.
I understand the ACDFC is not required to provide any person reasons for its rejection of any application.
Applicant/ Guardian name / Applicant/ Guardian signature / Date
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