Mount Emerald Wind Farm Community Benefit Fund

Section 2: Project Overview

Please note that Eligible Projects (please refer to the Fund guidelines) will be provided preference in assessment and any grant of funding. If insufficient space, information can be supplemented with maximum of 1 additional page as an attachment.
2.1 Project name and description
2.2 Project location (Please be specific)
2.3 What issue is the project trying to address in the community? Provide an overview of the proposal /project (approx. 30 words).
2.4 Who will benefit from the project?
2.5 When is the expected start and finish date of the project?
2.6 Do any time constraints apply?
2.7 If necessary, upload any additional project information (maximum 2 pages) as a Word or PDF document. If downloading this Application Form to post do NOT include original documents.

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Tenure and Storage
2.8 Land/building improvements – do you own/lease the property?

Yes - OwnYes - Lease (please describe below)NoN/A
2.9 Equipment – where will the equipment be stored?

At the location provided in section 2.2Somewhere else (please describe below)
2.10 Purpose – will other organisations be able to use the facility/equipment?

YesNo
If applicable, please provide any additional details relating to Tenure and Storage
Organisation Structure
2.11 Please provide a brief summary of how your organisation sources revenue for operational costs.

Section 3: Application for funding

Applicants may be required to provide additional evidence before funding is granted.
3.1 What is the total value of the grant requested from the Fund (GST inclusive)?
Total Grant (GST inclusive) = Total project expenses - Total other income.
3.2 Has the Applicant or Organisation applied for, or secured, any other source of funding for the project? For example grants: Federal, State or Local government funding, applicant's own contribution, in-kind or non-monetary support.

YesNo
3.3 List all sources and amounts of funding (GST inclusive) applied for and/or secured for this project.
3.4 Is partial funding possible for your application?

YesNo
3.4(a) Please describe how partial funding may occur (i.e. distinct portions that can be funded, that will achieve specific outcomes without the need for further funding)

3.5 Please upload copies of any quotes that you have obtained to support your application. Quotes from local suppliers and businesses are preferred.

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Section 4. Information for applicants

Applications are considered by the Advisory Committee soon after the deadline dates of 31 January and 31 July. Recommendations are made to the Trustee who decides on the distribution of funds.
Notification

Applicants should expect to be notified whether their application has been successful or unsuccessful by approximately 2 months after the closure of the relevant round. If you have not received any correspondence after this time, please contact communityfund@ratchaustralia.com

If Successful:

If your application has been successful you will receive a Letter of Offer, which will require confirmation of your acceptance. Upon acceptance, you will be required to provide additional information, including your bank details (with supporting evidence).

Acquittal of the funds will be required within 6 months of project completion, which requires:

- details of the project outcomes,

- evidence of how the funds have been spent, and

- certification by an authorised person within the organisation.

If Unsuccessful:

If your application has been unsuccessful, you will receive notification from the Fund administrator.

We encourage you to reapply, as we often receive far more applications than we are able to fund.

Some useful hints when reapplying:

- review the Fund Guidelines to ensure your project is eligible for funding (Section 3),

- show clearly how your project aligns with the objectives of the Fund (Section 2.4), and

- ensure your project costs are easily understood (quotes are very useful).

Section 5. Applicant Statement
1. I acknowledge that if successful in receiving a grant, the Applicant will be required to report on the outcome of the project and complete an Acquittal of all expenditure. This may also include publicly acknowledging the support received from the Fund or supplying images/testimony for use in publicising the Fund.

2. I acknowledge and agree to the Mt Emerald Wind Farm Community Benefit Fund Guidelines: Terms and Conditions for eligibility for funding.

3. I confirm that the information provided in this application form is true and correct to the best of my knowledge and that if any information is false or misleading that any offers of funding may be withdrawn or funding provided is to be repaid to the Fund.
Signature

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Name of authorised representative

First NameLast Name
Date

Section 6: Privacy Policy
RATCH-Australia Corporation will only use information provided in this form to assess the application and to contact the Applicant in case of any enquiries. RATCH-Australia Corporation's Privacy Statement can be downloaded here. If you have any questions please email: communityfund@ratchaustralia.com
Should be Empty:

	Describe each expenditure item in order of priority	Quote (Yes/No)	Total (GST inclusive)
Priority 1
Priority 2
Priority 3
Priority 4
Priority 5
Priority 6
Totals

MEWF Community Benefit Fund Application Form

Section 1: Applicant information

Section 2: Project Overview

Tenure and Storage

Organisation Structure

Section 3: Application for funding

Section 4. Information for applicants

Notification

If Successful:

If Unsuccessful:

Section 5. Applicant Statement

Section 6: Privacy Policy