North Queensland Zone Incorporated

Australian Outrigger Canoe Racing Association

North Queensland Zone Incorporated

ABN 64 460 160 637

PO Box 102, Belgian Gardens, Qld, 4810

Ph: 0416 468 503

NATIONAL TITLE and OVERSEAS EVENT

TRAVEL ASSISTANCE SCHEME

Club must be based more than 300km from National Titles Event venue. Payment amounts are capped at a maximum of $50.00 per person.

Only 1 application per person may be submitted for National Titles and

1 application per person for Overseas Travel Assistance Scheme

per calendar year.

APPLICATION FORM

Please complete this form and answer each question thoroughly

This form is to be completed by the main contact person for the team/crew attending the event on behalf of all paddlers in that team/crew.

The questions asked, and information sought in this application form are aimed at seeking sufficient details about the club &/ team to enable NQ Zone AOCRA to reach a fair decision in relation to the application.

Please provide information in a concise manner and ensure that a clear statement is presented under each item.

All additional pages and documents are to be attached. Please use the checklist provided at the end of this form.

The application form and attachments are to be lodged with:

The Secretary

NQ Zone AOCRA Inc.

Incomplete applications will be rejected. Applications lodged by facsimile will not be accepted.

Application monies are paid after

the relevant event (National or Overseas)

has been completed.

Event to be attended: ______

Your Club name: ______

ABN:______

GST Registered YES NO

Postal Address: ______Postcode______

Team Contact Person: Mr / Mrs / Ms / Miss / Other ______

Position in Club:______

Contact details of contact person

Business Hours:(_____)______Facsimile:(_____)______

Mobile:______Email: ______

Name of Team: ______

Number of Crews applying for funding: ______

Step One: Club Endorsement

Please attach a letter on club letterhead providing the clubs’ endorsement of each paddler attending the event. Each paddler’s name must be listed in the letter.

Only Clubs that are based a distance of 300km or more from the relevant National Title event are eligible for funding under this grant. All Australian based club members are eligible for funding to attend an event overseas.

Note: where composite teams (as approved by NQ Zone AOCRA from time to time) apply, only those team members whose Clubs are based a distance of 300km or more from the relevant National Titles event are eligible for funding (eg 20 members of a composite junior team – with 10 members within 300km – only the 10 remaining team members will be eligible for funding)

Step Two:

For National Titles: list all team members, AOCRA ID number, their affiliated club and distance from National Titles event.

For Overseas Events: list all team members, AOCRA ID number, their affiliated club and the country of the event.

Step Three:

Please indicate how your Club/Team will acknowledge a grant, if your application is successful.

President: Secretary:

Signature: Signature:

Name:Name:

Date:______Date:______

Checklist:

• Have you completed all sections of this form?
• Have you attached Club endorsements for all team members listed on this application?

PROUDLY SUPPORTED AND FUNDED BY THE FOLLOWING ORGANISATIONS