Funding Request Form

Applicant Details:*
Your organisation

Please provide an overview of your organisation below.
Eg. are you affiliated with a national organisation? What is your structure and formal setup, if applicable (society, trust, charity etc)
Organisation overview:
Your funding request

Please give a clear and concise summary of your request - bullet points are acceptable. (500 Word limit). You may provide additional supporting information in the drop box if required. Please consider:

1. What is the idea?
2. Who is the idea for?
3. Who will you be partnering with?
4. Where will the idea be implemented?
5. How will the idea be implemented?
6. How will the idea impact the advancement and of support children, young people and their families in New Zealand, to facilitate involvement in their communities through participation in physically active and healthy lifestyle activities?
Funding request description:*
Expected outcomes in terms of community participation in activity: *
Please indicate community partners for the proposed idea. (More than one partner can be selected):*

PreschoolSchoolDisability ServicesCommunity OrganisationYouth GroupOther
Please indicate target groups for the proposed idea. (More than one group can be selected):*

All AdultsMenWomenFamilies / WhānauChildren & Young PeoplePeople with a DisabilityOlder AdultsEthnic MinoritiesLGBTQ+People with Socio Economic DisadvantageOther

Please outline projected costs associated with the idea under any relevant categories:

Total funding requested (and whether full or part of the sum needed):*
Any conditions for payment (e.g. subject to approval by another group):*
Requested means of payment (eg. Trust purchase and supplies, recompense on receipt, funds paid in advance):*
Funding required by:*

DayMonthYear
Date
Additional supporting information:

Cancelof
Please add us to the Tauawhitia Trust email communication list:*

YesNo
I understand that the information I have provided will be used for the purposes as described at the start of this application form.*

YesNo
Privacy – do you wish all or any part of this request to be kept anonymous except as required by law?*

YesNo
Declarations *
Sign below to complete the declaration:*
Date
Should be Empty: