Community Grant Application Form

Community Grant Application Form
Advance Ashburton Community Foundation

Advance Ashburton Community Foundation is a registered Charitable Trust, established in 2003. The Foundation provides a trusted, effective and simple way for individuals, families, clubs and organisations to give long-lasting benefits to charitable causes within the Ashburton district.

Every donation Advance Ashburton receives is from the generosity of those that have the Ashburton District at heart. Donations are made either as a one-off, a regular payment through payroll giving, or from a gift in a Will. Every donation the Foundation receives is invested, and the income generated is distributed to worthy, local causes that honour the wishes of the donor.

Advance Ashburton is also the local Funding Manager for The Tindall Foundation. This means that Advance Ashburton has been chosen by the Tindall Foundation to distribute their generosity on their behalf. Their chosen causes being to support families and whanau and social services within the Mid Canterbury region.

Before you complete your application, you may find it helpful to read these tips:

First check that your project is eligible to receive Advance Ashburton funding. You will find the eligibility criteria here.

We are interested in hearing about the difference your project will make. Being really clear about the outcomes of your project is very helpful.

Remember, we won’t assess your application on how well you present the information, so please don’t worry about fancy formatting. Keep your answers clear and concise. Double-check you have completed your application in full, utilise the checklist provided.

If you are unsure, give us a call. We are happy to offer guidance in any way that we can.

- Name of Organisation
- Legal Status
- Charities Commission Registration #
- Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Contact Person
- Position
- Phone Number
  
  Area CodePhone Number
- Email
  example@example.com
- Is the organisation GST registered?
- Initiative Name
- Amount Requested

- Provide details of your organisation
- Please list the organisations and networks with which your organisation maintains regular contact with

- Describe your initiative/project.
- How have you established the need for this in our community?
- Who and how many people will benefit from this?
- How do you plan to make it happen
- Will you be collaborating with others?
- If yes, please list who these will be. Remember to consider all those involved in pre, during and post initiative/project
- Give names, qualifications and experience of the key people involved with this initiative/project

- We understand you wish to carry out this initiative to make a difference. We are interested to know how you are going to go about achieving this, including what outcomes you are planning to achieve, the actions you will undertake to achieve these outcomes as well as identifying how you will measure your success.
  
  Please complete the following table giving specific details. It is important to note that if funding is approved you will be asked to report on this.
- Be sure to think about these outcomes carefully. Initial approval of funding and the monitoring of the effectiveness of your initiative can be based on what you state here. You may write as much information as needed and click "Add New" if you wish to include additional outcomes.

- Please list the details of any other sources of funding that you have applied for to help fund this initiative / project.
- Please indicate (where relevant) how funding for this initiative will be sustained when/if the Advance Ashburton Community Foundation funding ceases.
- Please provide the names and contact details for two referees.
  Referees should be individuals who can comment on the integrity and the services provided by the applying organisation, and preferably be external to this organisation. At least one referee must be Ashburton District domiciled.
  
  Referees must not be directly involved with Advance Ashburton Community Foundation (e.g. trustees, committee members or staff members).

- 1. Is your organisation Incorporated?
- 2. Do you have Charities Services registration or an IRD Income tax exemption letter?
- Please upload your Charities Register Registration or IRD Income tax exemption letter.
  
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- 3. Please upload your most recent financial accounts. (These are not required to be audited but must not be more than 12 months old.)
  
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- 4.Please upload the list of your governing body officers' names
  
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- 5. Please upload the list of your current executive staff (Including qualifications and experience)
  
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- 6. Please upload your project budget - including all income and expenditure expected. For any capital purchases, supply at least 2 quotes.
  
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- 7. Please upload a pre-printed deposit slip or bank account details verified by the bank.
  
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- - This application has the formal approval of our controlling Board / Committee / Authority.
  - To the best of our knowledge the information provided in this application is true and correct.
  - It is acknowledged that any decision made by Advance Ashburton Community Foundation is final and we accept that no reasons for such a decision may be given, nor any correspondence entered into.
  - We agree that any donation made will be used for the purposes specified in our application or as directed by Advance Ashburton Community Foundation. In the event that we cannot comply with the conditions of the donations within the specified time, we will advise the Foundation of the surrounding circumstances to enable a review of the donation to take place.
  - We authorise Advance Ashburton Community Foundation or its agents to make enquiries of any third parties, (even though that may involve disclosing information contained in the application) or undertake audits of our organisation in connection with this application.
  - We acknowledge that this application and details of the Trustees’ decision may be shared with other funders and made publicly available.
  - We agree to immediately inform Advance Ashburton Community Foundation should the initiative depart from that agreed.
  - We authorise Advance Ashburton Community Foundation to use our name/photograph for publicity purposes and participate in promotional work as may be reasonably required by the Foundation, free of charge.
  - We will acknowledge the support of the Foundation in our literature, announcements and interviews.
  - If the donation was for a capital item, the applicant will supply a receipt of purchase upon request.
  For and on behalf of: This application needs to be signed by two authorised members of your organisation. Signatories must not be directly involved with Advance Ashburton Community Foundation (e.g. trustees, committee members or staff members).
- Date
  
  MonthDayYear
  Date
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