2017/18 Community Grants

2017/18 Community Grants

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Our Reference
Date Received

2017/18 COMMUNITY GRANTS

ACQUITTAL REPORT

GENERAL INFORMATION

Grants Details

Name of Project
Grant Amount
Grant Reference No.

Organisation’s Details

Name of Organisation
Address
Postcode
Website

Auspicing Organisation’s Details

Name of Organisation
Address
Postcode
Website

Contact Person – responsible for the daily co-ordination of the project

Name
Organisation
Position
Telephone
Mobile
Facsimile
Email

DECLARATION

I declare that the 2017/18 Community Grant program grant of $ provided by the Shire of Gingin has been spent in accordance with the purpose and conditions for which it was granted and that the financial statements are a true and fair record of the transactions for this project.

Name
Signature
Date

2017/18 COMMUNITY GRANTS PROGRAM

EVALUATION REPORT

Please read all of the questions before you start writing your evaluation report. If you feel that you will require more space than that provided on the attached forms, please present your entire Evaluation Report on plain A4 paper.

  1. Briefly describe what the Grant funds were expended on.
  1. Outline the impact of the event on the community/attendees.
  1. Have the goals of this project been achieved?

No Yes (please provide details)

  1. Has a post evaluation been completed? (Community sentiment/feedback)

No Yes (please provide details and findings)

  1. What acknowledgement did the Shire of Gingin receive as a result of this grant? Required

(please provide details – for example the publication and date, copies of advertising)

  1. Please provide a copy of any media releases, brochures or news articles in support of your initiative. Required

Please list what articles you are attaching below.

  1. How satisfied were you with the 2016/17 Community Grants Program?

Very Satisfied / Satisfied / Neither Satisfied
nor Dissatisfied / Dissatisfied / Very
Dissatisfied
  1. Are there any other comments you would like to make about the grant program?
  1. Please attach copies of paid invoices/receipts and, if applicable, photographs to support acquittal. Required

(please list attachments)

2017/18 COMMUNITY GRANTS PROGRAM

FINANCIAL REPORT

BUDGET

$ /

ACTUAL

$

INCOME

2017/18 Community Grant
Other Grant (please detail) -
Other Grant -
Other Grant -
Sponsorship
Donations
Other (please list)

TOTAL INCOME

EXPENDITURE

Advertising and Promotion
Transport
Equipment
Administration Costs/Public Liability Insurance
Presenters/Speakers
Venue Hire
Other (please list)
TOTAL EXPENDITURE
SURPLUS* / DEFICIT

* Any unused 2017/18 Community Grants Program funds are to be returned via cheque and made out to the Shire of Gingin. Please then post to:

Shire of Gingin

Coordinator Community Services

PO Box 510

GINGIN WA 6503

2017/18 Community Grants Program – Acquittal Report

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