Town Centre Dollar for Dollar Grants application form

TOWN CENTRE DOLLAR FOR DOLLAR GRANTS APPLICATION FORM

For further information or questions regarding this form, please contact Council via 9911 6555.

Eligibility Criteria

Eligibility type: *

Applicants must be a business or organisation that operates within the City of Canada BayApplicants must be an incorporated legal entity, an enterprise or auspiced by an incorporated entityApplicants must be able to undertake and complete the proposed project from July 2021 onwardsApplications must have no outstanding grant acquittals or debts to the City of Canada BayApplicants must not have applied for any other City of Canada Bay grants for the same project

Select as many as apply to you or your organisation

Organisation details

Organisation Name *

Organisation's ABN *The ABN provided will be used to look up the following information: Entity name, ABN status, Entity type, Goods & Services Tax (GST), DGR Endorsed, ATO Charity Type, ACNC Registration, Tax Concessions and Main business location.

Postal Address *

Primary Website

Head of Organisation Title: *CEO or equivalent

Head of Organisation full name: *

Head of Organisation telephone contact: *

Head of Organisation email address: *

Contact for application

Contact full name: *Including title

Position held *

Applicant Admin Contact Other Phone Number *Must be an Australian phone number

Contact number: *For business hours

Applicant Admin Contact Primary Email: *

Banking Details

Account Name: *

BSB Number: *

Account Number: *

Prior Funding

Has your organisation previously received funding from us? *

YesNo

What was the name/title of the project?

What was the total funding received?Must be a dollar amount

What year was the project started?Must be a number and between 2000 and 2020. Please type the full year (E.G. 2020)

Project details

Project event or activity title *Must be no more than 30 words.

Which of the City of Canada Bay Community Strategic Plan (Your Future 2030) themes does your project/event or activity address?Tick as many that apply

If other, please specify:

Project start date: *Must be a date and between 1/7/2021 and 30/6/2022.

Project end date: *Must be a date and between 1/7/2021 and 30/6/2022.

Description of project, event or activity *Provide a brief overview of the project. What will the project include? Must be no more than 200 words

Will there be an entry fee? *

YesNo

Project, event or activity address: *

Project description

What outcomes are expected from this Project? *Must be no more than 200 words. Who in the City of Canada Bay community will beneﬁt? What will the beneﬁts be? How will the project be inclusive of the broader community?

What opportunities will be available for local contractors, suppliers, entertainers and performers to be involved in the delivery of the Project? *Must be no more than 100 words

How will your business or organisation manage/ coordinate/monitor the Project? *Must be no more than 100 words. How many people will be involved? How will it be planned, implemented and evaluated?

How will your business or organisation acknowledge Council’s support? *Must be no more than 100 words. Please address the acknowledgement requirements in the Funding Guidelines.

How will your project lead to sustainable town centre activation? *Must be no more than 100 words.

Project budget

Outline your project budget including details of other funding that has been conﬁrmed and applied for. Applicants must have suﬃcient funds to match 50% of the grant funds requested and the budget must balance (total income = total expenditure). Please include these areas in your budget INCOME and EXPENDITURE columns.

Income *Please provide a list of income (including amount and description for each)

Expenditure *Please provide a list of expenditure (including amount and description for each)

What is the total ﬁnancial support you are requesting in this application? *Must be a whole dollar amount (no cents) and no more than $3000

Documentation required

Copy of public liability insurance

Browse

For events in a Council venue or park

Declaration and Privacy Statement

I, the person making this application declare that;

I have read and understood the guidelines for the City of Canada Bay Dollar for Dollar Town Centre Grants Program; and
The information supplied in this application is to the best of our knowledge true, accurate, and complete.

In circumstances where funding is oﬀered for the event, which is the subject of this application, we undertake to observe the following conditions:

To use the funding only for the purpose outlined in the application
To ensure that any public health directions and/or restrictions related to the delivery of the event are fully adhered to
To seek written approval from Council prior to any signiﬁcant changes to the event and/ or the event budget
To acknowledge the Council’s assistance in any material relating to the event
To spend the monies within the stated period, except with prior written approval of Council
To return unexpended funds to Council
To submit Funding Acquittal Form prior to May 2022
Information relating to this project will be made public.
I declare that I am authorised to complete this application and have read and understood the declaration and privacy statement

Authorised Person's Name: *

Position held: *

Applicant Signature *

Draw signature|Type signatureClear

Date signed *