Indigenous Languages and Arts (Projects)—application form

INDIGENOUS LANGUAGES AND ARTS (PROJECTS)
APPLICATION FORM
Prior to completing this form
Applicants must have read the Indigenous Languages and Arts (Projects) programme guidelines,
available at http://arts.gov.au/topics/indigenous-arts-languages-and-culture/indigenous-languagesand-arts, prior to completing this application form.
Contact details
If you have any questions regarding the Indigenous Languages and Arts (Projects) Program, or if you
require a hard copy of the application form and guidelines posted to you, you can:
•
visit: www.arts.gov.au/indigenous/ila
•
email: [email protected], or
•
phone: 1800 006 992.
Closing date
Applications close at 5pm on 17 July 2015.
Please note that late entries may not be accepted.
Applications must be submitted by email to [email protected].
In exceptional circumstances only, applications can be posted to:
Indigenous Languages and Arts (Projects)
Ministry for the Arts
Attorney-General’s Department
4–6 National Circuit
BARTON ACT 2600
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SECTION 1: APPLICANT DETAILS
1: APPLICANT DETAILS
Legal name
of applicant:
Trading name of applicant
(if applicable):
ABN:
ACN:
Registered business
address:
Suburb:
State/Territory:
Postcode:
Are you registered for GST?
Yes
Legal Entity type:
Individual
No
Partnership
Incorporated Association
Company
Other
Other Details:
Do you have any overdue acquittals for
funding from the Australian Government?
Yes
No
If yes, please provide an
explanation:
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2: AUTHORISED PERSON CONTACT DETAILS
Please provide contact details for the person in your organisation who is authorised to enter into a Funding
Agreement with the Australian Government. If you are applying as an individual, please provide your contact
details here.
Title:
First
name:
Surname:
Postal address:
Suburb:
State/Territory:
Postcode:
Phone (daytime):
Phone (after hours):
Email address:
3: CONTACT PERSON
Please provide contact details for the person in your organisation who will be responsible for day-to-day contact
with the Ministry for the Arts.
Title:
First name:
Surname:
Postal address:
Suburb:
State/Territory:
Phone
daytime):
Phone (after hours):
Email address:
Page 3 of 14
Postcode:
Section 2: Project details
1: Project Details
Requirement
Answer
5. Project Title
6: Project summary
Please provide a summary of your project. This
summary will be used in media materials and on the
Department’s website if your application is successful.
7: PROJECT DATES:
What date do you expect to start your project?
This is the date that the component of your project that
is being funded through this grant will commence. This
date will be the date included in your funding
agreement.
What date would your project be publicly
accessible?
This is the date that the output of your project will be
performed, exhibited or otherwise available for the
public to participate in. Please list an opening and
closing date here. Full date and location details are to
be provided at Question 12.
What date do you expect to finish your project?
This is the date all components of your project being
funded through this grant will be completed.
Page 4 of 14
SECTION 3: ASSESSMENT CRITERIA
1: Assessment Criteria
Requirement
Answer
8. PROJECT DESCRIPTION:
Please provide a detailed description of your
project. When completing this question you
should consider the following questions at a
minimum:
•
What are you planning to do?
•
What is your vision for the project?
•
How are you planning to do it?
•
Why do you want to do it?
•
Who are the artists involved and what are
their responsibilities?
•
When do you intend to do it?
If you are requesting funding for a component of a
project, please describe the whole project and
provide details about the component that this
grant will fund.
9. Demonstrate how the project will meet the
objectives of the indigenous languages and arts
(projects) objectives and selection criteria.
Refer to section 5 of the ILA (projects) program
guidelines.
10. Demonstrate how the project will promote
audience engagement with indigenous arts and
contribute to a strong sense of cultural identity
and pride.
Refer to section 5 of the ILA (Projects) programme
guidelines.
11. Describe how your project will engage the
local community in the development phase.
12. Describe the communications and marketing
activities planned to promote the project.
Your response should include whether and how your
project will target diverse audiences such as Indigenous
Australians, young people, seniors, people with
disabilities and culturally and linguistically diverse
Page 5 of 14
Requirement
Answer
audiences
Page 6 of 14
13. Provide details of when members of the public will be able to
access the project.
Please provide details of where your project will take place and the projected audience numbers. If your project is
being delivered in a number of locations, please provide details for all locations. If you require additional space,
please duplicate this table.
Venue
Address
Activity
description
Page 7 of 14
Start date
End date
Estimated
attendance
SECTION 4: BUDGET
In this section you will be asked to provide details about your budget for this project. As you complete this
budget information please note the following:
• if you are registered for GST, you should exclude GST from both your income and expenditure
budget.
•
if you are NOT registered for GST, you should include GST in your amounts as this is part of the cost
of the project.
• the Total project budget (in the Expenses table at Question 15) must match the Total
anticipated income (in the Income table at Question 16).
14: HOW MUCH FUNDING ARE YOU REQUESTING THROUGH THE
INDIGENOUS LANGUAGES AND ARTS (PROJECTS) STREAM?
Please enter the total amount being requested and indicate if this amount is GST exclusive or GST inclusive
in the space provided below.
Year
Funding amount required per year.
Multi-year projects may be funded up to a maximum of $100,000 (GST exclusive) per year,
for a maximum of three years.
Enter the amount being requested against each Year in the table below.
2015
$0
2016
$0
2017
$0
2018
$0
Page 8 of 14
15. WHICH FINANCIAL YEAR/S DO YOU REQUIRE YOUR FUNDING TO
BE PAID?
PLEASE NOTE: This application form is for multi-year funding. A small number of projects may be funded over
two or three years. If you are requesting multi-year funding, please refer to section 4.6 of the Indigenous
Languages and Arts (Projects) program guidelines for eligibility regarding multi-year funding.
The information provided below must align with your project start date (at Question 7 of this form).
Year
Funding amount required per year.
Multi-year projects may be funded up to a maximum of $100,000 (GST exclusive) per year,
for a maximum of three years.
Enter the amount being requested against each Year in the table below.
2015
$0
2016
$0
2017
$0
2018
$0
16. List and describe estimated itemised expenses for the project,
including venue, production, promotion, programming,
administration and other direct costs associated with the project.
PLEASE NOTE: The Indigenous Languages Arts (Projects) stream will provide funding of up to $100,000 (GST
exclusive) per project per year for the development, production, presentation, exhibition and/or performance
of Indigenous arts projects. IF YOU WISH TO APPLY FOR MULTI-YEAR FUNDING, YOU MUST FIRST CONTACT THE
ILA (PROJECTS) TEAM BY EMAILING [email protected] or phoning 1800 006 992.
The ILA (Projects) stream is an open and competitive grants round.
Please note that a maximum of 30 per cent of your total project budget may be used for project administration.
Please refer to section 4.5 for further guidance regarding eligible project administration costs.
Include all expenses related to the project, including those covered by your contribution and other contributions
to the project. The Total project budget must match the Total anticipated income in the Income table at Question
16.
Please note funding through the Arts and Culture Fund can make up a maximum of 70 per cent of the total
project budget.
Page 9 of 14
Expenses – list and describe anticipated costs for Cost
your project
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
TOTAL project budget
$
Page 10 of 14
17. Please provide details for all anticipated income streams for your
project.
You should include all relevant income sources, such as this grant, applicant and other contributions, ticket sales,
sponsorship, merchandising and retail, other government support or grants, and any in-kind contributions.
Please note that a maximum of 30 per cent of your total project budget may be used for project administration.
Please refer to section 4.5 for further guidance regarding eligible project administration costs.
Income stream
Income
Indigenous Languages and Arts (Projects)
$
Applicant contribution
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Page 11 of 14
Is this income
source confirmed?
TOTAL anticipated income
$
18. Outline how this project represents value for
money.
19. Please state whether the project can still
proceed if unconfirmed sources of funding or
income detailed at question 16 don’t eventuate.
Page 12 of 14
SECTION 5: PROJECT PLANNING AND RISK MANAGEMENT
20. Describe your ability to deliver the project
within the specified timeframe and budget.
Your response should demonstrate that you have
adequately planned how you will deliver the project,
outline your capacity to manage the project and
demonstrate how will you will achieve your project’s
intended outcomes.
21. Describe the risks associated with your
project and how you plan to mitigate those risks.
Your response should demonstrate that you have
considered the following:
•
Are there any known planning or other
approvals required for this project?
•
What potential risks are associated with your
proposed project?
•
How will you reduce the likelihood or impact
of identified risks?
If you are requesting funding for a component of a
project, please describe the whole project and provide
details about the component that this grant will fund.
SECTION 6: SUPPORTING DOCUMENTATION
You must attach the following supporting documentation to your application:
a one page CV for each key person involved in the project, including project administrators and
artists
a draft project schedule that includes key dates for the duration of the project.
Additionally, if you have the following documentation, you should attach it to your application:
quotes, if you have them, to support your project budget
signed letters of current support from individuals, organisations, venues and other project
partners who have agreed to be involved in the proposed project.
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SECTION 7: DECLARATION
By submitting this application, I acknowledge that:
•
I have read and agree to abide by the Indigenous Languages and Arts (Projects) Program
Guidelines.
•
I/the applicant do not have any outstanding or unacquitted funding from the Australian
Government
•
I have completed all the questions required in this application form.
•
Contact details of successful organisations will be made available to the Minister for the Arts
and other members of parliament.
•
The Ministry for the Arts is required to publish details of funded activities, including the
recipient and the amount of funding received on the Attorney-General’s Department website.
The Ministry for the Arts may also share aggregated information with other Australian
Government and state and territory government agencies for reporting purposes. Any personal
contact information will be treated as confidential. Further information regarding privacy and
privacy requirements is at section 8.8 of the ILA (Projects) program guidelines.
•
I consent to my personal information being used in relation to the Indigenous Languages and
Arts programs (including Australian Government publications). I understand that if at any
future stage I wish to withdraw my personal information from use, I will give 30 days’ notice in
writing to the Ministry of the Arts [email protected].
•
I declare that the information I have supplied on this form is true and correct. I understand that
making false and or misleading statements in applications or the provision of false or
misleading information constitute offences under Sections 136.1 and 137.1 of the Criminal
Code 1995, and that these offences carry serious penalties.
•
my application may not be accepted if it is late or does not include all required support material
attached.
Name:
Position:
Date:
ENTRIES MUST BE RECEIVED BY THE MINISTRY FOR THE ARTS BY 5PM EST ON
17 JULY 2015.
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