Community Development Grants Program As at January 2013 Category Three- Page 1

Community Development Grants Program – as at January 2013 – Category Three- Page 1

Community Development Grants Program

Category Three:

(3)Quick Response Grant

Up to $2,000 per application

Please refer to the guidelines before submitting an application. We encourage you to discuss your application with the Council Officer listed on the website prior to submitting your application.

The purpose of the Community Development Grants Program is to enable the community and eligible organisations to work together with Council in delivering community programs, activities and events that contribute to making the City of Adelaide a creative and liveable city.

This category of funding is open year round and is available for residents, organisations, incorporated and unincorporated groups of the city. Please, read through the entire application form before beginning to ensure you have all of the information required to submit.

Complete an online application at or submit two hard copies of your application to:

Community Development Grants Program

City Community Program

Adelaide City Council

GPO Box 2252

ADELAIDE SA 5001

Or in person to

Customer Service Centre

Ground Floor

25 Pirie Street

ADELAIDE SA 5000

Please note that faxed or emailed applications will not be accepted.

Application Form– Cover Page

Name of Organisation (if applicable)
Street Address
Postal Address
Contact person and Position
Phone
Email
Name of Application
Amount of Funding Requested
Date of Submission

Please indicate which program priorities your application directly relates to (there can be more than one):

□Encourage residents and community groups to be engaged in local place making (neighbourhood development) activities

□Strengthen reconciliation practices

□Deliver inclusive responses to meet the needs of isolated and marginalised groups

□Create literacy initiatives to maximise participation

□Increases volunteer participation

□Promote civic engagement in decision making

□Provide access to learning, services and ideas

□Create opportunities for people to connect with their local neighbourhood

OFFICE USE ONLY
Date Application Received
Acknowledgment Letter Sent
File Number

Part One – Application Summary

Name of Application
Brief Overview of the Application
(Suggested 100 word maximum)
Who is the target group for your application?
(Refer to the guidelines for eligible groups)
How did you determine that this application was needed? What evidence do you have to support its development? (E.g. Discussions, observations, statistics)
What outcome/s are you seeking to achieve?
(Please ensure that you have read the Adelaide City Council’s Strategic Plan 2012-2016 and City Community Strategy 2012-16 to ensure that your outcome/s is consistent with those sought by Council)
How will you measure your outcome/s?
WHERE will the application take place (It must be within the boundaries of the City of Adelaide including any of the Park Lands)
What will council’s funds be used for (e.g. marketing, infrastructure hires, performance fees, insurance etc)
Start Date
End Date (if applicable)

What partnerships relate to this application and what will each partner contribute?

Partner / Contribution / Confirmed

Budget

Item / Amount
Total (must match funding amount requested)

Individual residents and unincorporated groups applying for funds to support a neighbourhood street party or small scale event on Council land (e.g. a Square or Park Lands) may be able to be covered by Council’s Ad Hoc Hirers Liability Policy at no cost (subject to discussion with Council’s provider). Please indicate whether you would like to apply for public liability insurance from Council:

□Yes, I do require Council’s Ad Hoc Hirers Liability Policy

□No, I do not require Council’s Ad Hoc Hirers Liability Policy

Community Development Grants Program – as at January 2013 - Category Three - Page 1

Checklist

Before submitting your application make sure you have:

Discussed your application with the relevant Council grants officer

Completed all sections of the application form

Submitted evidence of local support (for individual applicants)

Signed the application form

Kept a copy of your application for future reference

Applicant Certification

I certify to the best of my knowledge that the statements made in this application are true. I have read the Adelaide City Council’s Community Development Grant Program guidelines. I understand that should this application be approved by the Adelaide City Council that I would be required to accept the conditions of the grant in accordance with the Council’s accountability and reporting requirements.

Name of Delegated Officer
Position
Signature
Date

If this grant is being submitted under the auspice of another organisation please complete the following details.

Name of Auspice Organisation
Name of Delegated Officer
I certify that we are to be the auspice organisation for this application
Signature
Date

Community Development Grants Program – as at January 2013 - Category Three (3) - Page 1