Community Volunteer Support Grant

Community Volunteer Support Grant Application Form
Applicants are advised to read the Community Volunteer Support Grant guidelines available HERE prior to completing this form as applications not meeting the guidelines will be deemed ineligible. The maximum grant is $1000. Applications will be considered by Elected Members at the next available Council meeting.

If you require advice on how to complete this form, please contact Lower Eyre Council.

Telephone: (08) 8676 0400

Email: mail@lec.sa.gov.au
Part A - Applicant Details
I have read the CS-APP-04- Guidelines - Community Volunteer Support Grant*

YesNo
Please read the guidelines available HERE prior to completing this application form to make sure your project is eligible and you can meet all the grant requirements.
Name of organisation*
Number of senior female members*
Number of senior male members*
Number of junior members (under 18 years)*
Total number of members
Does your organisation have members with a disability?*

YesNo
Is your organisation incorporated?*

YesNo
The applicant must be an incorporated group to recieve funding under this program.
Incorporation number*
Does your organisation have an Australian Business Number (ABN)?*

YesNo
Australian Business Number
Is your organisation registered for GST?*

YesNo
Is your organisation insured?*

YesNo
You need to provide a copy of your organisation's Certificate of Currency (evidence of a valid and current insurance policy) to be eligible for funding.
Upload your Certificate of Currency here. *

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Organisation's address*

Postal Address

Postal Address Line 2

CityState

Post Code
Contact person*
Position in organisation*
Email Address*
example@example.com
Phone Number (day time)*
Please enter a valid phone number.Format: (0000) 000000.
Phone Number (after hours)
Please enter a valid phone number.Format: (0000) 000000.
Part B - Program Details
Program title*
Program location (where will the program be undertaken)*

Location address

Location address line 2

CityState

Post Code
Number of volunteers participating*
Program start date*

DayMonthYear
Date
Program completion date*

DayMonthYear
Date
Please provide a description of the training program or equipment required. *
Tell us what you are planning to do and how you will do it.
Who will benefit from the program*
Tell us about the groups and people who will benefit from this initiative.
How was the need for this program determined?*
Why do you need to do this program.
How will volunteers benefit from the program?*
What will volunteers gain from being involved?
How will your organisation acknowledge the financial support from Council?*
If your application is successful we would like your orgnisation to publicly promote our contribution.
Upload a copy of the applicant's most recent income and expenditure statement and balance sheet.*

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OPTIONAL - Upload any other relevant documents to support your application here.

These may include fliers or promotional material for the event or activity, or your organisation's Strategic Plan which addresses the need.
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Part C - Funding Sources
Has your organisation (including sub-committees and associated committees) received funding from the Lower Eyre Council, or other funding sources, in the past three years?*

YesNo
Please provide the source, purpose and amount of funding received from grants by your organisation in following table.
Funding received from grants over the past three years. *
Part D - Project Budget
The maximum grant is $1000. While there is no financial co-contribution required by clubs or organisations, this woudl be considered favourably.
What is the total cost of this project? *
Dollar amount
Project costs*
What is your income for this project?*
Dollar amount
Project income*
Council grant request for this project.
Upload quotes here*

To be eligible for funding you must provide evidence of your project costs.
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Part E - Acceptance of Community Volunteer Support Grant Conditions
Declaration

Please read the following conditions and complete the checklist. Incomplete applications will be ineligible for funding.
*
*
*
*
*
*
*
*
*
*
*
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Print Name*
Organisation*
Position*
Email*
example@example.com
Signature*
Date*

DayMonthYear
Date
Should be Empty:

Community Volunteer Support Grant Application Form

Part A - Applicant Details

Part B - Program Details

Part C - Funding Sources

Part D - Project Budget

Part E - Acceptance of Community Volunteer Support Grant Conditions