• Project and Applicant Details

  • Applicant Details

  • Please confirm you have Deductible Gift Recipient Item 1 Status and Charity Tax Concessions*
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  • Applicant Organisation

  • Project Description

  • Project Details

  • Project Start Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • End Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Which ATC geographic destination does the charity service?*
  • Is this a new or existing project?*

  • Beneficiaries

  • Implementation Plan

  • Complete the table below to outline how you plan to deliver your project, and when each milestone will occur. It is important to include enough detail to demonstrate the critical elements of project planning have been considered. KPIs should be specific and measurable.

  • Outcomes

  • Referees

    Provide details of two (2) referees that are able to comment either on the need for the project you are proposing, or your organisation’s ability to deliver the project e.g. a local business or community organisation such as a Council, Police Station, Library.

  • Referee 1

  • Referee 2

  • Budget

    Project budget: the budget is critical to the consideration of your Grant application. It is important that you be as specific and as accurate as possible.
  • Income*
    Rows

  • Declaration

  • This declaration and consent must be made by a person from the organisation submitting the Grant Application who has appropriate authority (such as Chief Executive Officer, Director, Chairperson or President) to declare and consent to the matters required.

    In my capacity with the organisation (Grantee) submitting the Grant Application, I declare that:

    1. The information supplied to the ATC Foundation to the best of my knowledge is accurate and complete.
    2. The Grantee will use the whole of the Grant exclusively for the purpose described in this application. The Grant will not be used for any other purpose.
    3. The Grantee will advise the ATC Foundation of any material change in the Project and/or its timeframes which may affect our ability to undertake or complete the Project by the Completion Date.
    4. The Grantee will not change the location of the grant as specified in the Application.
    5. The Grantee will provide an official receipt to the Grantor within such period after payment as required by the Grantor.
    6. The Grantee will keep detailed financial records sufficient to accurately report the use of Grant funds and enable Grant expenditure to be verified by the Grantor as required.
    7. We acknowledge that the details of the Grant will be made public by the ATC Foundation, including the name of the Grantee, amount of the Grant, and details of the Project.
    8. We will make ourselves available for Marketing and Communication opportunities
    9. The Grantee will operate in an ethical and legal manner whilst conducting this project.
  • Date*
     - -
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: