Funding Program:Community Language Schools Funding Program

Report Period:01/01/2017 to 31/12/2017

Total funding amount received in 2017: <Insert funding amount>

Section 1: Contact Information

Organisation name
Organisation address
Primary Contact Information (for this report)
Name
Position
Telephone / Mobile
Email

Section 2: Activity Completion Summary

In line with the Agreement between You and the Department: / Yes / No
Has the Activity been completed within the agreed timeframe?
Have agreed Deliverables/Milestones been met?
Has the intended outcome of the Activity been achieved?
i.e. To provide out-of-school-hours <Insert language>Language programs to eligible Victorian school-age students in 2017.
Has all the Funding approved for the Activity been used as agreed?

Section 3: Financial Acquittal

Section 3 of this report meets Your requirements for a Financial Acquittal for the Funding received.In addition, please remember that under the Agreement between You and the Department that You must:

  • Keep accurate records, including all receipts and tax invoices, in relation to the Activity and for everything You purchase with the Funding in accordance with any requirements set out;
  • Keep copies of student enrolment information and school accreditation documentation for accountability and audit purposes;
  • Provide access to, and copies of such records and documentation at any time to the Department or a third party authorised by the Department; and
  • Undertake an acquittal of funds received from the Department for the 2017 calendar year by completing the table in Section 4.

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VICTORIAN COMMON FUNDING AGREEMENT

FINAL REPORT - BASIC

DECEMBER 2015 VERSION 2.0

Section 4: Income and expenditure statement

Complete the table below to record expenditure against the funding received from the Department in 2017. (Add more rows as required.)

Activity Income for the period 1/01/2017 – 31/12/2017
Total funding received from DET in 2017 / $ <Insert funding amount>
Activity Expenditure for the period 1/01/2017 – 31/12/2017
Salaries / $ <Insert amount>
Professional development / $<Insert amount>
Curriculum resources / $<Insert amount>
Equipment (e.g. audio-visual, computers, hardware andsoftware) / $<Insert amount>
Other (e.g. rental of premises etc. Please itemise) / $<Insert amount>
Total funding expended / $ <Insert total amount>

Section 4: Declaration

I hereby certify that, to the best of my knowledge, information in this report:

  • Discloses all relevant information that the Organisation is required to report on in accordance with the Agreement for the Activity;
  • Is true and correct and without false or misleading statements; and
  • Relates to funding provided to the Organisationthat was expended to delivercommunity language programs to Victorian school-aged students outside school hours.

I acknowledge that the Department may seek from the Organisation additional information for the purpose of clarifying information provided in this report including attached supporting documentation.

CERTIFIED for and on behalf of <Insert organisation name ABN <Insert ABN, by the following authorised representative of <Insert organisation name.

Complete this section including your name and position details

Name and position of authorised representativeName: ______

Position: ______

Sign here: ...... Date: _____/_____/_____

Witness

Name of WitnessName: ______

Sign here: ...... Date: _____/_____/_____

Organisations must complete and submit a copy of the Annual Report 2017 to 28 February 2018.

PAGE 1

VICTORIAN COMMON FUNDING AGREEMENT

FINAL REPORT - BASIC

DECEMBER 2015 VERSION 2.0