QCPW Regional Grant Application 2015 – PDF

Regional Grants 2015
Application for Funding
Organisation details (or sponsoring organisation details)
Funds are only provided to non-Government organisations and/or not-for-profit
organisations.
Name and Postal address of the organisation and/or auspice organisation: include ABN
ABN:
Telephone number:
E-mail address: (required for receipt notification)
Event Organising Committee Details:
You must actively include and involve at least 5 organisations (both non-govt &
government) who work with children, young people, parents, carers and families as part of
the event planning committee
Member Name
Organisation
Email Address
Identify Event Region: ______________________________
Far North Queensland Region
North Queensland Region
Central Queensland Region
North Coast Region
South East Region
South West Region
Phone
Does your organisation hold appropriate insurance? Please ensure that your public liability
insurance covers the proposed event. Please specify the type of insurance cover held:
Insurance Policy Details: (attach copy of current certificate)
Overview of Regional Event: This section must be completed in 1,000 words or less.
Your Regional application will be judged against the following key criteria. Be sure to use
these criteria as headings in your proposal and refer to the guidelines.
1. Date of proposed events or activity
2. Location include address of proposed event
3. Description of the proposed activity, include estimated number of attendees. Please
write a statement to explain how your project will reflect the aims and theme of
Child Protection Week 2015 in your local community.
4. Promotion: outline how both the activity and Child Protection Week will be
promoted, and to whom (eg. brochures, posters, media etc).
Proposed Budget - Grants of up to $3000 (inclusive of GST) are available:
Please provide banking details for payment processing:
BSB:
Account Number:
Account Name:
Please provide itemised breakdown of anticipated costs:
Item
Total Funding requested
Amount
$
This document is a Tax Invoice. ACT for Kids (ABN 4705 1964 673) auspice body for the
Queensland Child Protection Week Committee
Amount: $3000.00 (inclusive GST) subject to funding approval.
To be eligible for funding your submission must respond to the selection criteria outlined
below.
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Facilitate a regional event that promotes the theme Protecting Children is
Everybody’s Business and reflects the interests and diversity of the region;
The event/activity must be completed within Child Protection Week 6-12
September 2015. In exceptional circumstances, applications for event/activities in
the week prior to Child Protection Week will be considered.
raise awareness of child abuse and neglect as an issue within local Australian
communities
promote local services available to support children and families who have
experienced child abuse and neglect, or are at risk
equip individuals and communities with knowledge and skills to understand child
abuse and neglect and empower them to take action
Funding submissions must reflect collaboration with other agencies within the region
(minimum 5 organisations required)
Application due date Monday 20 May 2015
I/we declare that the information provided here is, to the best of our knowledge, accurate
and complete. I/We agree to abide by the conditions of funding laid out in the application
form and understand that I/we will be responsible for completing an accountability of
expenditure report within one month of the completion of the activity.
Name and Title
Auspice Organisation
Signed: ______________________________
Date
Date: __________________
7. Lodging the Application Form
Applications must be received by close of business Monday 20 May 2015. No late
applications will be accepted. The application may be submitted via email only. Please send
completed forms to: [email protected]
Applicants will be notified of receipt of application via email and outcomes of the
submission early July 2015.
For assistance in completing your application contact the Child Protection Week Project
Officer, Caitlin King on 0418408062. For examples of previous regional events visit
www.childprotectionweek.org.au
Acquittal Process:
The acquittal statement must be completed and returned by the due date of 2 October
2015. Future funding will not be considered if this process is not completed.