Office Use Only All Criteria Met  Yes  No Records Number If No, is further information to be requested  Yes  No Additional Information Received Recommended for funding (Comments) Not Recommended for funding (Comments) $ Approved for Funding Yes No Final Amount Approved   Signature of Authorising Officer Date of Approval Applicant Details Name 1 Applicant Details Parent/Guardian Name (if under 18) 2 Postal Address 3 Phone Mobile Fax 4 Email 5 Age Club/School 6 Organisation/Group Details Organisation Name 7 Organisation’s main 8 aims/objectives Postal Address 9 % of membership residing Adult Members 10 within the District Council Junior Members 11 (U18) of Loxton Waikerie Contact Name Position in Organisation 12 Contact Phone Contact Mobile 13 Contact Email 14 Event Name and details 15 Include why you need this support Selection letter(s) should also be attached If you require more space please tick and attach additional information 16 Sport or activity type Location
Office Use Only All Criteria Met  Yes  No Records Number If No, is further information to be requested  Yes  No Additional Information Received Recommended for funding (Comments) Not Recommended for funding (Comments) Approved for Funding  Yes  No Final Amount Approved $ Signature of Authorising Officer Date of Approval Applicant Details Applicant Details 1 Name 2 Parent/Guardian Name (if under 18) 3 Postal Address 4 Phone Mobile Fax 5 Email 6 Age Club/School Organisation/Group Details 7 Organisation Name 8 Organisation’s main aims/objectives 9 Postal Address 10 Adult Members % of membership residing within the District Council of Loxton Waikerie 11 Junior Members (U18) 12 Contact Name Position in Organisation 13 Contact Phone Contact Mobile 14 Contact Email 15 Event Name and details Include why you need this support Selection letter(s) should also be attached If you require more space please tick and attach additional information 16 Sport or activity type Location
FINAL%20LW%20Youth%20Sport%20%20Cultural%20Sponsorship%20guidelines%20&%20application-1.docx