Office Use Only Grant Reference Number Date Received Acknowledged Regional Community Child Care Development Fund (RCCCDF) Operational Grants – Program Application Form Thank you for your interest in the Regional Community Child Care Development Fund – Operational Grants Program. Before completing this form, please ensure that you: Have read and understood all information in the Grants Program Guidelines. Contact the senior grants officer, Department of Local Government and Communities on (08) 6551 8700 or at to discuss your project proposal and how this will meet the objectives of the program. Section One Applicant Details – 1.1 Organisation Name of Organisation Postal Address Suburb Postcode Telephone Facsimile Website 1.2 Entity type Please tick the box which best describes your organisation: Incorporated association Unincorporated group Must apply under auspice of an incorporated Local government authority organisation or WA local government authority See question 1.4 Not for profit trust Not for profit company Organisation established an Act of Other Parliament Please detail: Aboriginal corporation A copy of the organisation’s Certificate of Incorporation is attached to this application: Yes
Office Use Only Grant Reference Number Date Received Acknowledged Regional Community Child Care Development Fund (RCCCDF) – Operational Grants Program Application Form Thank you for your interest in the Regional Community Child Care Development Fund – Operational Grants Program. Before completing this form, please ensure that you: Have read and understood all information in the Grants Program Guidelines. Contact the senior grants officer, Department of Local Government and Communities on (08) 6551 8700 or at to discuss your project proposal and how this will meet the objectives of the program. Section One – Applicant Details 1.1 Organisation Name of Organisation Postal Address Suburb Postcode Telephone Facsimile Website 1.2 Entity type Please tick the box which best describes your organisation: Incorporated association Local government authority Not for profit trust Organisation established an Act of Parliament Aboriginal corporation Unincorporated group Must apply under auspice of an incorporated organisation or WA local government authority See question 1.4 Not for profit company Other Please detail: A copy of the organisation’s Certificate of Incorporation is attached to this application: Yes