APPLICATION FORM COMMUNITY GROWTH FUND – Contact Details Name of Organisation: Contact Person: Contact number/s: Address: Postal Address: Website: Organisation Business Details Please select Is your organisation an incorporated body? Yes No If yes please attach proof If no, have you attached a letter from a sponsoring Yes No committee? Are you registered for GST? Yes No Do you have Liability Insurance” “Public Yes No If yes, please attach a copy of of Currency” “Certificate Have you applied for funding from the Shire for this project previously? Yes No If yes, in what year was the application made? Please attach information Is the project dependant on funding to proceed? Yes No Has the Shire previously assisted your organisation? Yes No If yes, please attach information Have you applied or are you intending to apply for Yes No other funding sources for this project? If yes, please provide details Summary” “Project Banking Details ABN: Name of Account: Name of Bank: BSB:
APPLICATION FORM – COMMUNITY GROWTH FUND Contact Details Name of Organisation: Contact Person: Contact number/s: Address: Postal Address: Website: Organisation Business Details Please select Is your organisation an incorporated body? If yes please attach proof Yes No If no, have you attached a letter from a sponsoring committee? Yes No Are you registered for GST? Yes No Do you have “Public Liability Insurance” If yes, please attach a copy of “Certificate of Currency” Yes No Have you applied for funding from the Shire for this project previously? If yes, in what year was the application made? Please attach information Yes No Is the project dependant on funding to proceed? Yes No Has the Shire previously assisted your organisation? If yes, please attach information Yes No Have you applied or are you intending to apply for other funding sources for this project? If yes, please provide details “Project Summary” Yes No Banking Details ABN: Name of Account: Name of Bank: BSB:
CGF_APPLICATION_FORM.docx