Major Fund application
Tū Manawa Active Aotearoa
About your organisation
Organisation name
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Organisation website/social media account
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Tell us about the purpose of your organisation and what you do
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0/150
What 'type' of organisation are you?
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Please Select
Incorporated Society
Charitable Trust
Social enterprise
Regional or Local Council
For-profit organisation
Primary/Intermediate School/Kura
Secondary School/Wharekura
Tertiary Education/Wānanga
Marae, Hapū, Iwi, Māori
If relevant, what is your New Zealand Business Number (NZBN) or Incorporated Society Number
Name and contact details of person submitting the application (e.g. Chairperson, CEO etc.)
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Role in organisation
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Is your organisation GST registered?
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Please Select
Yes
No
GST number
*
Organisation's bank account name
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Organisation's bank account number
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Please attach a PDF of your bank account name and number
*
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Application for funds
Project or programme summary - tell us the name of your project, what it is, where it will occur and who you will be working with
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0/250
What type of physical activity does your programme involve?
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Please Select
Play
Active Recreation
Sport
Is this application being submitted for a project that is provided in a kaupapa Māori context?
Please Select
Yes
No
Will the project be delivered in te reo Māori?
Please Select
Not at all
Mix of Māori and English
All in te reo Māori
Proposed start date
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-
Day
-
Month
Year
Date
Proposed end date
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-
Day
-
Month
Year
Date
Is this a new, existing or modified/expanded project or programme
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Please Select
New
Existing
Modified/expanded
What setting/s will your project take place in?
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Please Select
Community setting/s
Primary/Intermediate schools/Kura
Secondary Schools/Wharekura
Tertiary Education/Wananga
Marae
Home setting
Other
If any part of your project is to be delivered in schools/kura please advise when
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Please Select
Not in schools
In class time
Out of class time
If you selected 'in-class time' in the previous question, your application needs to be accompanied by an in-school delivery checklist. The checklist is available at https://bit.ly/3l5Sb9N. Please upload completed checklist below.
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Identify who your project aims to positively impact on (select all that apply)
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Tamariki (children 5-11)
Rangatahi (young people 12-18)
Young Women (19-24)
Disabled children or young people
Other
How do you know this project is needed? (i.e. who have you spoken to? What evidence or insights do you have?) Upload files - photos, videos etc. - if needed.
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0/250
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What are the key changes (outcomes) your programme is trying to bring about in the people and/or the communities you are working with? (name up to 3 outcomes)
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0/250
Taking the outcomes above, how will you know you have achieved them? What will you measure and how? (e.g. measuring changes via a survey, interviews, feedback from participants, case study, participation/physical activity information, attendance and project management records)
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0/250
Who will you be working with to deliver this programme? (Please include the organisations' names)
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0/100
What is the total cost of your project?
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What amount are you applying for from Tū Manawa Active Aotearoa?
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Please upload a budget that includes all the costs you are applying for and what they will be used for, and shows any other income against this specific project
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If there is a difference in the total costs and the amount you are requesting, how do you intend to fund the outstanding amount?
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0/100
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Conditions of application
I confirm that I am authorised to submit this application on behalf of the organisation, and that our directors and/or trustees and/or treasurer are aware of and support this submission.
*
Please Select
Yes
No
I have read the “Tū Manawa Active Aotearoa Community Guidelines 2020-2021”.
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Please Select
Yes
No
I will comply with the requirements set out in the“Protecting your information”section of the Tū Manawa Active Aotearoa Community Guidelines 2020-2021” and have advised my organisations’ Directors,Trustees and/or committee members of the information in that section
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Please Select
Yes
No
I confirm that information in this application is correct, and that any amount we receive as a result of this application will be used solely for the purposes specified in this application.
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Please Select
Yes
No
I acknowledge that Sport NZ/Sport Bay of Plenty has the right to audit the information provided in this application and the use of any funds granted. I will provide full cooperation in the event of such an audit being undertaken.
*
Please Select
Yes
No
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