NZCT Manawatū Active Communities Fund
Application Form for Activity / Sport Providers including schools, clubs, organisations
Is your application for a school/club/group?
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School / Kura
Sports Club / Organisation
Other Group
Tell us the name of that group.
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Name of person applying on behalf of the above group
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First Name
Last Name
Activity / Sport Provider Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number of best contact person
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-
Area Code
Phone Number
Email
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example@example.com
Age Group of participants you are targeting in this application.
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Have you approached other organisations for funding?
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Yes
No
Have you received support from the NZCT Manawatū Active Communities Fund in the past?
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Yes
No
If yes, please state the year and what was the purpose of the support.
Please outline what you require funding for.
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What are the barriers that you are trying to overcome to help people become more active?
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How many inactive people can you identify you will help with this application (e.g. a class of 30 students which has 11 inactive students).
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Purpose and kind of assistance needed
Add a description and a cost to each item
Item/Description/Total Cost
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Rows
Description (What & How many)
Total Amount in $
Club/Activity fees/Subscriptions
Uniform
Footwear
Equipment
Travel Costs
Individual/Group Coaching
Total $ applied for
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Please attach quotes related to the expenses you are applying for
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of
Provide an outline of your proposed costs
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Applicant's Signature (on behalf of the group)
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Disclaimer
If our application is approved, we:
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Rows
Confirmation
Will use the funds for the purposes originally stated in this application.
Agree to provide Sport Manawatū with all the evidence they may require regarding the use of the funds.
Agree to submit a report about the way the fund helped us on completion of the project.
Acknowledge that failure to submit the report may disqualify us from re-applying to the fund.
Allow Sport Manawatū to use the information we provide to help improve and perpetuate programme.
Will abide by the conditions of the Active Communities Fund.
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