COMMUNITY RESPONSIVENESS FUND - APPLICATION

This application form will be used to assess your application for funding.

Completion of this form is not an agreement to fund any application. Once you submit your application it will be assessed by a distribution committee.

Applicants will receive an outcome of their application once the committee has reviewed it.

The OrganisationStep 1 of 3

First Name *

Email *

Drivers Licence Upload *

Drop your file here or click here to upload

Please upload a valid copy of the Drivers Licence of the person completing this form.

Organisation Website / URL

Last Name *

Phone *

Postal Address *

Address Line 1

Address Line 2

City

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Certificate Upload (Inc. Society / Charities)

Drop your file here or click here to upload

Please upload a copy of your Certificate Of Incorporation of Charities Certificate.

Bank Slip Upload *

Drop your file here or click here to upload

Please upload a bank statement or bank deposit slip showing an account matching the organisation name on the organisation certificate.

Quote Upload

Drop your file here or click here to upload

If this grant is to be used for any equipment purchase over $500 please attach at least three quotes in the organisation name.

Name

180 Weymouth Rd

+64 9 972 1401

Mon - Fri: 9:00 - 17:30

COMMUNITY RESPONSIVENESS FUND - APPLICATION

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Application Details

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