THE BAROSSA COUNCIL COMMUNITY GRANT APPLICATION FORM (Please read the Community Grant Guidelines and complete all sections of this form) TBCPOC4450 Community Related Policy/Process Form Number: TBCFOR4452 Assistance Scheme Policy Manager Community and – Form Owner: Last Revised Date: June 2017 Facilities Development Manager Community and – Document Control: TRIM Reference: Facilities Development Date Approved: 7 June 2017 Next Review Date: June 2018 Date of Application: / / 1. ORGANISATION DETAILS Name of organisation (as it appears on the Certificate of Incorporation): Physical address of organisation clubroom/facilities/meeting place: Postal address of organisation: 2. CONTACT DETAILS FOR THIS ORGANISATION Name: Position: Postal Address (if no postal address for organisation, provide postal address for contact person): Mobile: Home Phone: ( ) Work Phone: ( ) Email: Preferred Method of contact Home Phone Work Phone Mobile Email
THE BAROSSA COUNCIL COMMUNITY GRANT APPLICATION FORM (Please read the Community Grant Guidelines and complete all sections of this form) Related Policy/Process TBCPOC4450 Community Assistance Scheme Policy Form Number: TBCFOR4452 Form Owner: Manager – Community and Facilities Development Last Revised Date: June 2017 Document Control: Manager – Community and Facilities Development TRIM Reference: Date Approved: 7 June 2017 Next Review Date: June 2018 Date of Application: / / 1. ORGANISATION DETAILS Name of organisation (as it appears on the Certificate of Incorporation): Physical address of organisation clubroom/facilities/meeting place: Postal address of organisation: 2. CONTACT DETAILS FOR THIS ORGANISATION Name: Position: Postal Address (if no postal address for organisation, provide postal address for contact person): Mobile: Home Phone: ( ) Work Phone: ( ) Email: Preferred Method of contact Home Phone Work Phone Mobile Email
Community%20Grant%20Application%20Form.DOCX