Funding Application for Lopdell Trust Arts Grant 2022
Contact Person
*
First Name
Last Name
Email Address
*
example@example.co.nz
Phone Number
*
-
Postal Address
*
Street Address
Suburb
City
State / Province
Postcode
Please provide a brief two line summary of your project:
*
Please explain the principal focus of your project and how it aligns with the Trust's objectives:
*
Date for proposed project:
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-
Day
-
Month
Year
Location of proposed project:
*
Amount requested:
*
Bank account name:
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First Name
Last Name
Bank account number:
GST Number:
Charitable Status:
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Yes
No
Registered Charities Number:
Detailed Project Description:
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Applicant Profile/Resume:
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Letter/s of Support:
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Program / Production Specific Info:
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Applicant's Name
*
First Name
Last Name
Signature
*
Please verify that you are human
*
Submit
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