Investing in women and girls since 1985

2017 GENERAL GRANTS APPLICATION FORM

Applications to be lodged by Friday24th March 2017

Email application inWordformat to:

Post: Level 9, 313 La Trobe St, Melbourne 3000

Organisation Details
Name of Organisation:
Australian Business Number (ABN):
Postal Address:
Organisations Website:
Head of Organisation:
Name and Title:
Phone:
Email:
Contact Person for Application
Name:
Position:
Phone:
Mobile:
Email:
Tax Status – Does the Organisation have:
  • ATO endorsement for Item 1. Deductible Gift Recipient? Yes No
  • ATO endorsement for Tax Concession Charity? Yes No
Note: Your organisation is not eligible if it does not have DGR & TCC
Project Details
Project Name:
Project Start Date: Project Completion Date:
Amount Requested: $ Total Project Cost: $
  1. Provide a brief project description (a short summary of the project in 1–2 sentences or dot points) (100 words)

  1. What is the project aiming to do? (150 words)

  1. What are the key steps you need to take to achieve this aim?
    (150 words)

  1. Why is there a need for your project?
    (include if it builds on existing work to date) (200 words)

  1. How will the project address the focus of the VWBT 2017 General Grants program?(refer to grants guidelines) (150 words)

  1. Who will benefit and how? (include how many women and or girls will directly benefit, age group, location and other demographics) (100 words)

  1. What are the expected outcomes?(what do you want to achieve?include both immediate and longer term) (150 words)

  1. How will you know if these outcomes have been achieved?
    (discuss evaluation or measurement of project’s effectiveness) (150 words)

  1. Outline how the project could be influential and or initiate positive change?(100 words)

  1. What does your organisation do and why is it best placed to conduct this project? (200 words)

  1. Outline the project implementation strategy including:
  • Timeline and if appropriate project stages
  • Who will be overseeing the project
  • Project personnel

  1. Please provide two referees, external to the organisation, who are able to speak about the project and your organisation. This should include a written reference from one of the referees:
Referee 1
Name:
Organisation & Position:
Phone:
Email:
Referee 2
Name:
Organisation & Position:
Phone:
Email
  1. How did you hear about the VWBT grants program? VWT website,
    e-bulletin, Our Community notice, VCOSS bulletin, WIRE notice, community networks, previously received a grant, other (pleaseindicate)

Project Budget

14. Outline your project budget including details of other funding that has been confirmed and applied for. The budget must balance (total income = total expenditure). Also advise if there are any partners for the project.

INCOME / $
Amount requested in this application
Other funding sources
Confirmed Funding (list name of funders and confirmed amount, including your cash contribution)
Unconfirmed Funding (if you have applied for other funding that is unconfirmed please list the name of the organisations applied to and amount)
In-kind contributions (include an estimated value for non-cash contributions such as services, equipment, time and materials)
TOTAL INCOME
EXPENDITURE
(Breakdown of individual items such as salaries, equipment, travel/transport, administration) / $
In-kind contributions (as above)
TOTAL EXPENDITURE

Please answer all questions, in numbered sequence

Please Note: In order to be eligible for consideration to receive a grant, applicants must, at time of application supply a copy of their notices from the Australian Tax Office endorsing the organisation for (a) Item 1. Deductible Gift Recipient (DGR), and (b) Tax Concession Charity (TCC) or written proof from ATO that they would be charitable but for their connection with government. Your organisation is not eligible if it does not have DGR & TCC.
For queries, phone Carolyn Munckton (03) 9642 0422 or email
CHECKLIST
Applications must include the following
  1. Responses to all questions in application form
  2. Copies of organisations ATO endorsement notices for both Item 1 DGR & TCC
  3. Contact details of two referees, with one providing a written reference
Email application to: by Friday, 24th March 2017.
Postal Address: Level 9, 313 LaTrobe St, Melbourne 3000
Decisions about successful applications are made by Trustees in
late July 2017

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