Hindmarsh Business Assistance Grant Application 2022/23

Business Assistance Grant Application 2022/23

Applications Close: 5pm on Friday 10 February 2023
Please note: Before proceeding with your application, have you:

1 ) Prepared the Business Bank Statement

2) Completed a Risk Assessment Form

3) Prepared any quotes/information that these funds would be used to purchase

4) Organised written consent from the property owner for any Streetscape Applications (where applicable)

5) Read the Business Assistance Grant Guidelines

We suggest you collate any appropriate documents ready for upload prior to commencing, to avoid any issues with the online application.

If you need to leave this document at any time before you have submitted the application, ensure you hit 'save' at the bottom of the page. This form does not save automatically.

Business Details
Business Name*
Street Address*

Street Address

Street Address Line 2

Town State

Post Code
Business ABN*
Owner/Manager*
Project Manager*
Phone Number*
E-mail*
example@example.com
Brief Summary of Operations:*
If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au

Grant Application
Application Date:*

MonthDay Year
Date
Category Applying For:*
Amount Applying For:*
How much is your Business contirbution? (must be $1:$2 Shire Grant)*
If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au

Project Details
Provide a brief description of your project and how funding will be used:*
How will Hindmarsh Shire Council's contribution be recognised? (Signage, Facebook Post, thank-you letter, editorial, etc.) :*
How will your projects success be measured? (including number of employment opportunities gained if applicable)*
How will the project result in (or work towards) job creation/retention?*
If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au

Budget

Financial and In-Kind Contributions
Are there any contributions you will be making toward this project?*

In-Kind/Voluntary LabourFinancial (cash)No
Will funding be sought from other sources?*

YesNo
Budget

Labour/Tasks, Goods/Equipment, and Services

Labour/Tasks (Rate per hour: $25 unskilled, $40 skilled)

	Name of Labour/Task (e.g. preparing shop front for painting)	Hours (e.g. 10)	Rate/Hr (e.g. $25)	Total (e.g. $250)
1
2
3
4
5

Labour/Tasks Total:
$

Goods/Use of Equipment: (Rate per hour: $20)

	Name of Goods/Equipment (e.g. use of sander for sanding)	Qty/Rate - Unit/Hr (e.g. 10 x hours at $20)	Total (e.g. $200)
1
2
3
4
5

Goods/Equipment Total:
$

Services

	Name of Services Provided (e.g. consultant advice)	Rate/Quantity (e.g. 2 x hours at $100)	Total (e.g. $200)
1
2
3
4
5

Services Total:
$
Budget

Income/Expense
The following Budget Template needs to be completed for your project. The income and expense amounts should be the same. Add your In-Kind/Voluntary Labour as well as your Goods and Services expenses. If you are receiving an external funding or contributing financially please include this as income.

Income and Expenses (Income and Expense Total should equal the same):*

	Name of Income	Income Amount $	Name of Expense	Expense Amount $
1
2
3
4
5
6

Income Total:*
Expense Total:*
If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au

Risk Assessment
A risk management plan needs to be completed for you application to be considered. Have you completed a downloaded Risk Management Plan prior to this application? (If no, there will be an online template you can fill out now)*

YesNo
Please prepare your completed Risk Management Form for submission. There will be a field where you will be required to upload this document at the end of this application.

Please fill out the following Risk Management Template (ensure you consider all risks and include these in the below):

	Name of Risk	Likelihood	Consequence	Control/Treatment
1
2
3
4
5
6
7
8

Example Template

Supporting Documents
Business Bank Statement*

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Risk Assessment:

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Quotes*

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Other Supporting Documents

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If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au

Checklist

This is to ensure you have completed all necessary steps to be considered for this grant.
Have you (you must do all of these before submitting):*

Attached a copy of your businesses bank statement to demonstrate financial viabilityCompleted a Risk Assessment for the project (template provided on website if needed)Provided quotes/information on specific items that the funds will be used to purchaseObtained and attached written consent from the property owner for streetscape applications (where applicable)To the best of your knowledge, the business does not have any outstanding rates, fees or invoices to Hindmarsh Shire Council
Please indicate if your business requires further assistance with business opening/expansion/new employee assistance, or would like to work 1:1 with our Economic and Community Development team who can guide you through Council's regulatory processes.*

Yes, I require this.No, I do not require this.
If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au

Signatures and Submission
Project Manager Signature*

Clear
Owner/Manager Signature*

Clear
If you have any questions or queries, contact out Community Development Officer.

Ph: 03 5391 4444, or email : grants@hindmarsh.vic.gov.au
Should be Empty:

Business Assistance Grant Application 2022/23

Business Details

Grant Application

Project Details

Budget

Budget

Budget

Risk Assessment

Example Template

Supporting Documents

Checklist

Signatures and Submission