CITY OF HOBART COMMUNITY DEVELOPMENT GRANTS PROGRAM APPLICATION FORM COMMUNITY QUICK RESPONSE GRANTS

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CITY OF HOBART COMMUNITY DEVELOPMENT GRANTS PROGRAM APPLICATION FORM COMMUNITY QUICK RESPONSE GRANTS

Before you begin Please ensure that you read and understand the Guidelines, the City of Hobart Strategic Plan and other relevant strategies as listed in the Guidelines. Essential criteria Community grants are intended to support activities in the Hobart municipal area that result in benefits for the Hobart community and align with an aspect of the relevant City of Hobart Strategies. Please check the Guidelines to ensure that your group and your project are eligible. If you are unsure, or need help completing this form, please contact: Mark Joseph, Community Activation Coordinator 6238 2839 How much can you request and when? Up to $500. Requests for funding for more than these amounts should be made in the twice-yearly grant programs: www.hobartcity.com.au/community/grants. Quick Response applications may be submitted year-round but as funds are limited please speak to a contact officer to check fund availability before submitting an application. Submitting your application Submission by email is preferred but you may submit a hard copy. In order to ensure a quick turnaround for this application, please include all of your supporting documents in the one email or envelope. By email to: By post to: grants@hobartcity.com.au Community Grants City of Hobart GPO Box 503 HOBART TAS 7001 When will a decision be made? You should receive a decision within four weeks of receipt of your application. 2 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

APPLICANT DETAILS Organisation/Group Name Street address Postal address Primary contact /title Contact number/s Email address Web address Australian Business Number (ABN) It is a requirement of the Australian Taxation Office that any payee who does not have an Australian Business Number (ABN) must complete a Statement by a Supplier form. This must be submitted with your application. A copy of this form can be found on the City of Hobart website: www.hobartcity.com.au/community/grants. Is your organisation/group incorporated? YES / NO (No you need to be auspiced) Is your organisation non-profit? YES / NO (No you must match this grant) Is your organisation registered for GST? YES / NO Have you previously been awarded a grant by the City of Hobart? YES / NO What was it for? When did you receive it? When did you acquit this grant? 3 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

What is the applicant organisation s aim/mission? Auspice Organisation Un-incorporated groups must attach a confirmation letter from an incorporated organisation see a sample at: www.hobartcity.com.au/community/grants If your application is successful you will need to provide a copy of your Auspice Agreement. Organisation/Group Name Street address Postal address Primary contact /title Contact number/s Email address Web address Australian Business Number (ABN) 4 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

PROJECT DETAILS *The details on this page will be made publicly available. Project name* Funding Requested * (maximum $500 ) $ Purpose* Tell us why you need the funding. This description will be made public should your application be successful. (Maximum 250 words.) Project Dates* Start Date Completion Date 5 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

Community Alignment Please briefly describe how your activity aligns with one or more of the following strategies. (Max 250 words each.) You can find copies of each strategy on the City of Hobart website: www.hobartcity.com.au/community/grants Social Inclusion Strategy 2014-2019 Multicultural Strategy 2014-2019 Youth Strategy 2014-2019 Children & Families Strategy 2014-2019 6 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

Positive Ageing Strategy 2014-2019 Equal Access Strategy 2014-2019 Venue Where will the activity take place? Budget Please detail how the money will be spent. You may provide a single page budget as an attachment to this application. 7 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

City of Hobart Acknowledgement Please describe how the City will be acknowledged for this support. Support Material Applicants are requested to submit relevant support material to complement their application. Only one copy of the application and support material is required. If posting your application, please do not staple documents. Essential Confirmation of Auspice Organisation (if applicant is not incorporated) Optional Budget Evidence of community support (maximum two letters/emails) Acceptable formats and quantities for support material Word documents, PDF, JPEG, mp3 files. Maximum 2MB per file if emailing. 8 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

Declaration This declaration must be signed by a person authorised to sign on behalf of your organisation. I certify that the information given on this form is complete and correct, to the best of my knowledge. I understand that approval of the grant is subject to mutual agreement between the City of Hobart and the applicant. I understand that if the City of Hobart approves the grant: o o o This organisation will be required to enter into a formal contract. Funds will only be used for the project described on this application. An acquittal report will need to be submitted at the end of the project, outlining the results of the project. I agree to ensure all necessary approvals, permits and bookings are obtained prior to the activity for which the grant is provided, taking place. I acknowledge the City of Hobart does not accept any liability or responsibility for the proposal in this application and that it is the responsibility of the applicant or their auspice organisation to provide appropriate insurance cover. I consent to the public release of the project title and description provided in this application. Signature Date Name Position in organisation Witness Signature Date Witness Name 9 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form

Checklist Have you: Answered all the questions? Attached a letter of confirmation from your auspice organisation (if required)? Attached a Statement by Supplier (if required)? Provided a budget? Attached all support material? Signed the form and had it witnessed? 10 City of Hobart Community Development Grants Program Community Quick Response Grants Application Form