Funding ApplicationForm /
Small Grants Program 2015/16

Applications open: Monday 5 January 2015

Applications close: 5pm, Friday 6 March 2015

Ph: 9936 8100Email: 17/01/2014

NORTH SYDNEY COUNCIL
Small Grants Program - Funding Application Form 2015/16

North Sydney Council provides small financial grants for local community based, not for profit organisations. Funding amounts are generally in the range of $500 - $2,000 and should be seen as a contribution rather than a commitment to fund the entire service.Read the Council’sCommunity Grants and Subsidies Policy (D4-08),available fromCouncil’s website,before completing this application form.

To receive assistance an organisation must meet the following criteria:

  1. Be an incorporated not for profit organisation based in and/or servicing the North Sydney Local Government Area (LGA).

or

Be a community group in the local area auspiced by an incorporated not-for-profit organisation.

  1. The organisation must be offering a project principally for the benefit of residents of North Sydney LGA.
  2. The organisation must be undertaking a project within the time frame specified.
  3. An application form must be completed and submitted by the closing date.
  4. Previous Council funding gained through the program must have been acquitted.

Exclusions:

Activities which promote or advance a specific religious or political belief system cannot be considered for funding under this program.

Project Assessment Criteria:

  1. The project contributes to Council’s Strategic ‘Social VitalityOutcomes’as articulated in theNorth Sydney Community Strategic Plan 2013-2023.
  2. The project outcomes are a priority for the community and aligned with demonstrated community needs or aspirations.
  3. The project fosters innovative, creative ideas and solutions to community need.
  4. The project is inclusive and has a significant reach into the community.
  5. The project stimulates ‘Community’ or ‘Cultural Development’ in North Sydney.
  6. The project contributes to community connectedness, reduces social isolation or engages previously disengaged members of the community.
  7. The project promotes social equity or justice.
  8. The project enhances the quality of service delivery.
  9. Organisational Capacity:
  • The applicant has the experience and expertise to deliver the activity effectively;
  • A history of appropriate financial management; and
  • Satisfactory acquittal of previous Council funding.
  1. Project Budget. The proposed budget includes income and expenditure targets.

Recommendations based on the information provided will be forwarded to Council for Section 356 Grants (Donations) to Community Organisations. Determinations will be made annually for the following financial year, as part of Council’s budget process.

You will be advised of the outcome of your application by August 2015.

If your application is successful, an Evaluation Report on the expenditure of your grant must be completed and received by Council by 30 June 2016.

For more information contact Council’s Administration Officer,

Community Development Department on Ph 9936 8100

ORGANISATION DETAILS
Name of Organisation:
Contact Person:
Postal Address:
Suburb: / State: / Postcode:
Phone: / E-mail Address:
Website:
ABN:
Is your organisation registered for GST: Yes No
Is your organisation a Not for Profit organisation: Yes No
NOTE:if you are not a Not-for-Profit organisation, you will need to approach a Not-for-Profit organisation to auspice your project and complete this application on your behalf.
Applications from individuals or sole traders will not be considered.
Incorporation Registration Number:

PROJECT DETAILS

Project Name:
Describe your project (what you are going to do or provide, e.g. service, product, program, event etc):
Proposed start and end dates for your project:
Location/Venue:
How many people living in or percentage of the community, in North Sydney LGA will benefit directly from this project?
Audience Capacity (if an event/performance):
How will you promote your service/performance to the local community?
How was the need for the project identified?
Is the project? (please tick)
New One-off project Expanded On-going
How will your project benefit the North Sydney community and contribute to the ‘Social Vitality Outcomes’ (refer to Direction 4) of theNorth Sydney Community Strategic Plan 2013-2023: (Tick the option most appropriate to your project)
Engage and connect communities and reduce social isolation.
Celebrate a culturally diverse community by facilitating and supporting local community cultural organisations.
Facilitate and enhance arts and cultural programs and facilities.
Enhanced community safety and accessibility including support for drug and alcohol abuse, domestic violence, safety at home.and inclusive programs for sex or gender diverse people.
Promote health and wellbeing, including recreation and leisure activities for people of all ages and abilities.
Facilitating access to affordable housing and low cost accommodation as well as assistance for people at risk of homelessness.
Encourage lifelong learning and volunteering.
Provision of community services, facilities, and information for children, families, young people, older people and people with a disability.
Who will be the main beneficiary/target group for the project? (Tick the most appropriate boxes)
Aboriginal and/or Torres Strait Islander people
People from culturally diverse communities
Early childhood 0-6 years
Children 6-16 years
Adolescent 12-16 years
Youth 16-24 years
Young people and/or their families
People over 55 years
People affected by addiction or other drug and alcohol issues
Women
People affected by domestic violence or other violence/assault issues
People or communities who are socio/economically disadvantaged
General Public
Support for carers
People who are Gay, Lesbian, Bisexual, Transgender, Intersex (GLBTI))
People who are homeless (or at risk of)
People with a disability
People with mental health needs
Other - please state

FINANCE AND MANAGEMENT

Has your organisation received funding from Council before? / Yes No
If yes, has your organisation submitted an acquittal report to Council for previous funding?
NOTE: Acquittal reports for funding for the 2014/15 financial year are due 30June 2015 / Yes No
Project Budget
What is the amount of funding being requested in this application (excluding GST) / $
If you are granted less than this amount will your project be able to process? / Yes No
If the total cost of the project is more than the amount requested, please provide the total cost of the project / $
Does your organisation already receive funding from Local, State, or Commonwealth Governments? / Yes No
If yes, does this project receive any local, State or Commonwealth Government funding? / Yes No
Project Costs / Amount $
Salaries
Production (staging, audio, lighting etc)
Promotion and marketing
Administration/Overheads
Materials
Contractors
Suppliers
Other costs - Please specify below
Total expenditure / $
Project Income / Amount $
North Sydney Council proposed grant
State Government funding
Federal Government funding
Other income - please specify below
Total income / $

Funding Conditions

  1. Organisations receiving a grant are required to acknowledge North Sydney Council’s assistance on publicly available material asociated with the project. Examples include any media release, award submissions, brochures and posters, and television promotions.

This can be achieved by displaying the following statement: This project has been assisted by North Sydney Council’s Small Grants Programand displaying the North Sydney Council logo.

  1. Successful organisations will be advised by August 2015 and a valid tax invoice (plus GST if applicable) must be received at North Sydney Council by the date advised on the successful funding letter.
  1. Funds must be spent on and for the purposes of conducting the program as endorsed by Council.
  1. The program must be completed in line with the details outlined in your grant application.
  1. If you have left over money after the completion of the project, or if your approved project does not go ahead, you must give the leftover money plus GST back to Council.

DECLARATION and Signature

A person holding an office bearer position within the organisation must complete this form
On behalf of ______, I declare
that the information provided in this application is true and correct, and that if successful an Evaluation Report on the expenditure of the grant will be completed and received at Council by 30June 2016.
Signed:Date:
Management Committee Position:

CHECKLIST for submitting applications

Follow this checklist to ensure you have completed your application correctly. Have you:

Answered all questions on the Application Form

Provided aContact Name and phone number(s)

Included your last AGM minutes with audited financial statements

Included all GST information

Included any additionalsupporting information/documents

Completed the Declaration is signed and is enclosed

Please ensure that your organisation’s Application Formis complete with all relevant documents attached and returned to Council no later than 5pm, 6 March 2015.

Signed: Date:
PRIVACY STATEMENT
Personal details requested on this form will only be used for the purpose of processing your application. The supply of information by you is voluntary. If you cannot provide or do not wish to provide the information sought, the Council may not be able to process your application. Access to the information is restricted to Council officers and other authorised people. You may make application for access or amendment to information held by Council. Applications by members of the public to view Council's records are subject to the provisions of Council's Privacy Management Plan, Section18 Government Information (Public Access) Act 2009 Schedule 1 - Government Information (Public Access) Regulation 2009.
I have read and understand the Privacy Statement
Signed: ...... / Date: ......

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