Albury Wodonga Connected Communities
Grant Application Form
Applicant Organisation
Specific details of your organisation
Organisation Name
Australian Business Number (ABN)
Street Address
Postal Address
If the same as the street address, just write as above.
Website
Contact Person
Position Held
Phone
Email
Registered for GST
Yes
No
Organisation Profile
Tell us a bit about your organisation
Brief Description of Your Organisation
0/100
Group Demographics
Please provide some information on your group, the number of members, average age and anything else you feel is relevant to showcasing the best of your organisation.
0/100
Location of Principal Activities
0/100
Does your organisation already bank with the Bendigo Bank?
Yes
No
Are you willing to speak to a member of the Bendigo Bank staff to discuss the banking requirements of your organisation?
Yes
No
Community Project
Tell us more about the proposed project
Project Name
General Description of the Project
Please ensure to detail how the project will benefit the community (maximum 200 words)
0/200
Project Benefits
What specific issue or need will this project address?
0/100
Project Outcomes
What are the expected outcomes or effects on the participants/beneficiaries from this project?
0/100
Commencement & Duration of the Project
Detailed Costings of the Project
Please ensure to upload a budget file in the Supporting Documentation below
0/100
Your Organisation's Contribution
Provide details of your organisations contribution to this project, both monetary and non-monetary (eg. Volunteer hours are generally valued at $45 per hour)
0/100
Government & Other Support
Please provide details of any Government or other support you have applied for and received for this project
0/100
Have you received funding for this project or another in the past?
Yes
No
If Yes, please provide details:
0/100
Funding Amount Requested from AWCC
Bronze - $2,000
Silver - $5,000
Gold - $10,000
Community Engagement
Over and above the benefits your project will provide to the community, how else will your organisation continue to provide engagement with the local community?
Bendigo Bank Promotion
How will your organisation help promote the Bendigo Bank in the community and the work Albury-Wodonga Connected Communities does to assist the development of opportunities in the region?
0/100
Direct Organisational Engagement
If your organisation is successful in obtaining a grant, what forum and/or event will be held in order for an AWCC Board Member to provide the grant and prepare social media posts? Eg. Committee Meeting, AGM, etc
0/100
Declarations
Declaration to be signed by the President and Authorised Representative
Name of Signatory
Position Held
Name of Signatory
Position Held
I am authorised by my Applicant Organisation named in this application to make this application on its behalf.
I confirm that the Applicant Organisation agrees to the terms and conditions relating to the grants of Albury Wodonga Connected Communities Ltd.
I confirm that all information provided in or with this application is true and complete.
The Applicant Organisation acknowledges that Albury Wodonga Connected Communities Ltd is under no obligation to make a grant even though the Applicant Organisation meets all the guidelines and eligibility criteria requirements.
I will upload an Excel spreadsheet outlining the Project Budget as part of this submission.
Signed for and on behalf of the Applicant Organisation:
Signature
Date
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Month
-
Day
Year
Date
Signature
Date
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Month
-
Day
Year
Date
Supporting Documentation
Please tick the appropriate options below and upload the supporting attachments where requested.
Completed Application
Yes
No
Project Plan (Applications >$10,000)
Yes
No
Copy of ABN Registration
Yes
No
Copy of Public Liability COC
Yes
No
Supporting Documentation Upload
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