Please note: when completing this form please use ‘tab’ or the ‘arrow keys’ to go to the next question or click on the next question to continue
Section one: Questions about your organisation
1. / What is the legal name of your organisation?
Please provide your organisation’s registration number (as per the Companies office):
2. / Has the organisation above received funding from the Ministry of Social Development (MSD), including the Ministry of Youth Development, before?Choose an itemYesNo
If yes, please provide the organisation’s MSD Provider ID (if known):
Please provide the organisation’s GST number (if known):
3. / Please provide details of someone we can contact if we require more information. This person will also receive all communications from the Ministry of Youth Development
Name:
Position:
Contact phone number: / Choose an item0304060709 / Cell phone number:
Email:
Street address: / ,Town:,City:Postcode:
Postal address (if different from above): / ,Town:,City:Postcode:
4. / Please provide details, and examples, where you have experience in delivering youth focused financial literacy education either in school, community and workplace settings.
Section two: Questions about your initiative
1. / What is the name of your initiative?
2. / Tell us briefly about the initiative you would like funded? (limit of500 words)
3. / When will your initiative start and end?
Initiative will happen fromto.
Note: initiatives need to begin from 1 February 2015. If the initiativehas already started or has been completed, then it is not eligible to be funded.
4. / Explain how your initiative will deliver Financial Literacy skills to disadvantaged youth(limit of500 words).
5. / How does your initiative demonstrably develop young people’s skills, knowledge, thinking and behaviour, and/or dispositions in Financial Literacy(limit of500 words).
6. / How does yourinitiative benefit young people aged 12 to 24 years old; either in school, community or workplace settings(limit of500 words).
7. / How does yourinitiativedemonstrate value for money(limit of500 words).
8. / How does your initiative contribute to independent measures of improvement in Financial Literacy Skills (e.g. Personal Financial Management Unit Standards)(limit of500 words).
9. / How many young people will your initiative likely target?
10. / Where will your initiative be delivered (i.e. city, town, region)?
11. / How much will your initiative cost? (GST exclusive)
12. / How much of this are you asking for from the Financial LiteracyFund?
13. / If the initiative cost is greater than the amount you are asking from the Financial LiteracyFund, how much of this difference has been secured and/or confirmed?
14. / In the table below, please provide a description of what the Financial LiteracyFundgrant will be used for and the amount:
Description / Expense / Amount
(GST exclusive)
Total Financial Literacy Fundfunding requested(this amount should be the same as question 12)
Section three: Declaration required (Note: electronic copies without signatures are acceptable as long as both the Name and Position fields are completed)
Declaration:
I declare that:
- The information in this funding application is accurate to the best of my knowledge.
- I havedelegation on behalf of my organisation.
Name:
Position:
Date:
To apply please complete the funding application form and email it to: .Applications are to be completed and returned electronically (as a word document).
Applications close12pm (midday) on 2December 2014.
Please note that late applications will not be accepted.
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