17 Start date Event completion date 18 Amount requested $100 (competition is held within South Australia or within the Sunraysia district) $200 (competition is held interstate) $400 (competition is held overseas) 19 Estimated Cost of $ Trip 20 Will your activity still be able to proceed if only partial Details: Yes funding was received? No Funding Support It is encouraged that individuals and groups seek funding/sponsorship from other sources. Will you be seeking Yes Please list details below funding from 21 No elsewhere? Where from? How much? Is it confirmed? $ Yes No $ Yes No $ Yes No Checklist Have you checked the following? All sections of the application are complete Individuals have attached a copy of their selection letter from the governing sporting association or cultural organisation Attached additional information if you have ticked the box in question 15 requiring more space Individual Agreement to Funding Conditions has been signed If required, an authorised representative of the sponsor organisation has signed the Organisation Agreement to Funding Conditions Individuals Agreement to Funding Conditions I hereby certify that the information contained herein is a true and correct record to the best of my knowledge Name (printed) Parent/Guardian if under 18 Signature Date Applications may be received throughout the Return Completed Application to: Community Grants Program year – please allow for up to District Council of Loxton Waikerie PO Box 409, Loxton SA 5333 8 weeks for approval Enquiries: Sue Schultz, Community Development Officer Phone: 8585 8000 Email:
17 Start date Event completion date 18 Amount requested $100 (competition is held within South Australia or within the Sunraysia district) $200 (competition is held interstate) $400 (competition is held overseas) 19 Estimated Cost of Trip $ 20 Will your activity still be able to proceed if only partial funding was received? Yes Details: No Funding Support It is encouraged that individuals and groups seek funding/sponsorship from other sources. 21 Will you be seeking funding from elsewhere? Yes Please list details below No Where from? How much? Is it confirmed? $ Yes No $ Yes No $ Yes No Checklist Have you checked the following? All sections of the application are complete Individuals have attached a copy of their selection letter from the governing sporting association or cultural organisation Attached additional information if you have ticked the box in question 15 requiring more space Individual Agreement to Funding Conditions has been signed If required, an authorised representative of the sponsor organisation has signed the Organisation Agreement to Funding Conditions Individuals Agreement to Funding Conditions I hereby certify that the information contained herein is a true and correct record to the best of my knowledge Name (printed) Parent/Guardian if under 18 Signature Date Applications may be received throughout the year – please allow for up to 8 weeks for approval Return Completed Application to: Community Grants Program District Council of Loxton Waikerie PO Box 409, Loxton SA 5333 Enquiries: Sue Schultz, Community Development Officer Phone: 8585 8000 Email:
FINAL%20LW%20Youth%20Sport%20%20Cultural%20Sponsorship%20guidelines%20&%20application-1.docx