AGL Hydro Community Fund

Application Details
Please ensure that you have read and understood the AGL Hydro Community Fund - Guidelines before completing this application form.

Please fill out this form to the best of your ability. Some questions asked may not be relevant to you or your organisation. Please write ‘NA’ in these spaces.

Should you require any assistance in filling out this form, please contact AGL’s Hydro, Project Coordinator, Lachlan Sturt on 1800 039 600 or send an email to AGLCommunity@agl.com.au.

If you require additional space, please attach additional documentation to this application form.
Key Contact
Name:*

First NameLast Name
Position:
Phone:*
E-mail:*
Registered Address:*

Street Address

Street Address Line 2

CityState

PostcodeCountry
Is this the same as your postal address?*

YesNo
Postal Address:

Street Address

Street Address Line 2

CityState

Postcode
Organisation details
ABN:*
Name:*
Email:*
example@example.com
Website:
Registered Address:*

Street Address

Street Address Line 2

CityState

Postcode
Postal Address:*

Street Address

Street Address Line 2

CityState

Postcode
Which area do you operate in?*

Mount Beauty / Falls CreekEildon & surroundsDartmouthOther

Organisation Information
Please provide a brief overview of your organisation or community group, identifying the goods and/or services provided to the local community.*
Formal legal status of the organisation:*

Incorporated Association: usually locally focused not-for-profit community groups with limited funds and resources, operating in the local area or stateCompany Limited by Guarantee: usually larger not-for-profits, charities registered with the ACNC (Australian Charities and Not-for-profits Commission), or housing and aged care providers.Non-trading: usually groups serving their members such as a member owned art co-op or childcare group proving community services to its members, function under the ‘co-operative principles’Indigenous Corporation: Aboriginal and Torres Strait Islander groups. The structure considers indigenous customs and traditions. Corporations holding or managing native title.Other
Has your organisation received funding or support in kind from AGL in the past 12 months?*

YesNo

Description, Amount or in-kind & Date:*

Project or Initiative Details
Name of project / initiative:*
Location (which communities will be involved and how will they benefit from this project / initiative?):*
Description of project / initiative:*
Start Date:*

DayMonthYear
Date
End Date:*

DayMonthYear
Date
How will your organisation use the grant?*
Have you gained approval from the landowner for this project / initiative?*

YesNo

Project / Initiative Key Facts
How many people / animals do you expect will directly benefit from this project / initiative?*
How would the community benefit from this project / initiative?*
How does your project / initiative align with the AGL values of Bring on tomorrow, Can do. Will do, Be safe. Be supportive?*
What key focus areas does the project / initiative address?*

EducationYouthEnvironmentHealth, safety and wellbeingCommunity infrastructureArts and cultureEconomic developmentSocial welfare

Breakdown of spend:*

Next Steps
If you are successful, you will be required to:*
Include the required documentation with your comprehensive application. This may include:*
You may be requested to prepare a five-minute presentation (PowerPoint, sketch, diagram, speech, image etc.) that outlines your application. If you are, please include:

Key Contact