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                                                                      2010-11 Children’s
                                                                      Capital Program
                                                                      Minor Capital Grant
                                                                      Acquittal Certificate


This form must be completed by two authorised officers of the organisation that received the grant
funding at the end of the grant period.

By signing this grant acquittal the signatories declare that they are authorised to sign on behalf of the
organisation.

We certify on behalf of



(Name of funded organisation)

that funding received from the Department of Education and Early Childhood Development for the 2010-11
Minor Capital and Equipment Grants has been expended appropriately to purchase or replace one or more of
the following items:

     air conditioning                  storage for equipment


     fencing                           outdoor play equipment or environment


     furniture                         shade structures for outdoor play areas


     educational resources             water tanks


     other, please specify:




Amount of Grant Funding received
     $2,300

     $4,000


Name and Location of Service (if different to the funded organisation)



(name of service)
(location of service)


Authorised Persons


(Name of authorised person)



(Position)

………………………………………………………………………………………………………………………..…
(Signature of authorised person)   (Date)




(Name of authorised person)



(Position)

………………………………………………………………………………………………………………………..…
(Signature of authorised person)   (Date)




Please send this completed form by 30 November 2011 to your local DEECD
Regional Office addressed to:
 Region                 Name              Title                         Address
 Barwon-South                             Quality Improvement Project   PO Box 2086, Geelong, Victoria
                        Marianne Reilly
 West                                     Officer                       3220
                                          Program and Service
                                                                        Level 3, 295 Springvale Road,
 Eastern Metro          Iwona Jonasz      Adviser Community
                                                                        Glen Waverley, Victoria 3150
                                          Partnerships
                        Alison Clark      Manager Children's Services
 Gippsland                                                              PO Box 381, Moe, Victoria 3825
                                          and Partnerships
                                          Manager Access &              PO Box 403, Benalla, Victoria
 Hume                   Gerda Flint
                                          Participation                 3672
                                          Manager Children’s Services   109 Armstrong Street North,
 Grampians              Marita Toohey
                                          Reform                        Ballarat, 3350 Victoria
                                          Manager Service Orientation   PO Box 442, Bendigo, Victoria
 Loddon Mallee          Annette Millard
                                                                        3552
                                          Unit Manager, Children and    4 Hartington Street, Glenroy,
 Northern Metro         Veronica Hunt
                                          Youth Partnerships            Victoria 3064
                                          Manager Quality
 Southern Metro         Nicole Regan      Improvement, Learning and     P.O Box 692 Dandenong 3175
                                          Transition
                                          Acting Manager                Level 3, Whitten Oval
 Western Metro          Kim Knersch       Partnerships and Service      417 Barkly Street, West Footscray
                                          Development                   VIC 3012

				
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posted:11/23/2011
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