Your Federal Quarterly Tax Payments are due April 15th Get Help Now >>

Application GeneralCommunitySupportForm by 7bO719VH

VIEWS: 4 PAGES: 18

									There is one round of funding per year for projects to be held during January to December
the following year.

Complete applications are due by 12th June 2012 (check Financial & Legal documentation
requirements on page 19). Applications will not be accepted by fax.

POST:
City of Monash
Monash Community Grants Program
PO Box 1
GLEN WAVERLEY VIC 3150

EMAIL:
monashgrants@monash.vic.gov.au

HAND DELIVER TO:
Civic Centre (Ground Floor Reception)
City of Monash
Monash Community Grants Program
293 Springvale Road
GLEN WAVERLEY VIC 3150
                                               OFFICE USE ONLY
Oakleigh Service Centre
                                               Applicant Name: __________________________________
City of Monash
Monash Community Grants Program                Amount Requested: $_______________________________
3 Atherton Road
OAKLEIGH VIC 3166                              Amount Granted: $_________________________________
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application


  CONTENTS


SECTION 1: SUBMITTING THE APPLICATION ................................................................................ 3
SECTION 2: FURTHER INFORMATION ............................................................................................. 3
SECTION 3: MONASH LANGUAGE ASSIST ...................................................................................... 4
SECTION 4: APPLICATION CHECK LIST .......................................................................................... 4
SECTION 5: ORGANISATION DETAILS ............................................................................................. 5
SECTION 6: PROJECT SUMMARY ...................................................................................................... 7
SECTION 7: CASH FUNDING REQUEST ............................................................................................ 7
SECTION 8: WHAT ARE YOU GOING TO DO? ................................................................................. 8
SECTION 9: WHY ARE YOU DOING THIS? ....................................................................................... 8
SECTION 10: WHO WILL BENEFIT? ................................................................................................... 9
SECTION 11: HOW WILL YOU SPEND THE FUNDS IF SUCCESSFUL? ........................................ 9
SECTION 12: HOW WILL YOU KNOW IF YOUR PROJECT HAS BEEN SUCCESSFUL? .......... 10
SECTION 13: FACILITY HIRE FACT SHEET ................................................................................... 11
Office use only: APP No _________ ...................................................................................................... 15
SECTION 14: HALLS MANAGEMENT VENUES BOOKING REQUEST 2013 .............................. 15
SECTION 15: OTHER COUNCIL FACILITY HIRE REQUEST ........................................................ 16
SECTION 16: PRINTING REQUEST ................................................................................................... 16
SECTION 17: FINANCIAL & LEGAL DOCUMENTATION ............................................................. 16
SECTION 18: LOCAL EMERGING ARTIST FINANCIAL & LEGAL DOCUMENTATION ......... 16
SECTION 19: CERTIFICATION .......................................................................................................... 16




                                                                                                                             P a g e |2
                2013 Monash Community Grants Program
    Community Support, Hall Hire Booking and Printing Funding Application

    SECTION 1: SUBMITTING THE APPLICATION

    Make sure your application is complete by checking the application checklist on page 4.
    If submitting a hardcopy application, please ensure it is clear and legible. If hand written,
     please ensure it is clearly printed using black ink.
    Please keep a copy of your application for future reference
    Incomplete, faxed or late applications will be deemed ineligible
    Please do not submit your application bound, in display folders or plastic sleeves.

     Please submit your applications by Close of Business of Tuesday 12 June 2012
                     and mark it attention to MICHELLE MILLER
By Post:                                By E-mail:
City of Monash                          monashgrants@monash.vic.gov.au
Community Support Program
PO Box 1
GLEN WAVERLEY VIC 3150

Hand delivered to Civic Centre                 Hand delivered to Oakleigh Service Centre
(Ground Floor Reception):                      City of Monash
City of Monash                                 Community Support Program
Community Support Program                      3 Atherton Road
293 Springvale Road                            OAKLEIGH VIC 3166
GLEN WAVERLEY VIC 3150


    SECTION 2: FURTHER INFORMATION


                               Community Grants Contacts:

Julius Peiker                                  Michelle Miller
Coordinator Community Development              Community Development Administrative Officer
Ph 9518 3531                                   Ph 9518 3649


                                    Arts Grants Contact:

Fatima Almeida
Cultural Development Officer
Ph 9518 3569
                    All email enquiries: monashgrants@monash.vic.gov.au
                                Website: www.monash.vic.gov.au
                               TTY (Hearing Impaired) 9518 3655



                                                                                          P a g e |3
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application

 SECTION 3: MONASH LANGUAGE ASSIST




 SECTION 4: APPLICATION CHECK LIST

      Applicant or Organisation has attended a Monash Community Grants Information
       session.
       Details of information sessions and application writing workshops are as follows:
Date            Time      Session                             Venue
Monday           2:30pm   Community & Arts Grants             Clayton Community Centre,
16 April 2012       -     Information Session & Grants        Theatrette,
                 4:30pm   Writing Workshops.                  Cooke Street, Clayton.
Tuesday          7:00pm   Community & Arts Grants             Monash Seminar & Training Centre.
1 May 2012          –     Information Session & Grants        1a Atherton Road, Oakleigh
                 8:30pm   Writing Workshops.
Thursday         2:00pm   Community & Arts Grants             City of Monash, Civic Centre.
3 May 2012          –     Information Session & Grants        Function Room. 293 Springvale Road,
                 3:30pm   Writing Workshops.                  Glen Waverley
Thursday        10:30am   All day Grants Clinic. Drop in at   City of Monash, Civic Centre.
31 May 2012         –     anytime to receive assistance        Meeting Rooms 2 & 3.
                 5:30pm   with your submission.               293 Springvale Road,
                                                              Glen Waverley
      Policy and Procedures Document has been read.
      Organisational details have been completed (pages 5-6)
      Cash Funding Request has been completed (page 7 - where applicable)
      Hall Hire Booking Request has been completed (pages 15-16 - where applicable)
      Other Council Facility Hire has been completed (page 17 - where applicable)
      Printing Request has been completed (page 17 - where applicable)
      Have provided Financial and Legal documentation (page 18)
      Signed application “Certification” (page 18)
                                                                                         P a g e |4
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application


 SECTION 5: ORGANISATION DETAILS
(All correspondence in relation to this application will be forwarded to the contact details below).

Applicant/Organisation Name:


Postal Address:                                       Suburb:                     Postcode:


Phone:                                                FAX:

Website:

ABN (Yes or No)                                       ABN (if applicable):
If no please attach 'Statement by a supplier'
form
GST Registration (Yes or No)                          Incorporated Assoc. (Yes or No)
                                                      Certificate No.

What is your total membership?

How many of your members reside in the City of Monash?

Of your membership that reside in the City of Monash,
how many are active members?



WHAT IS THE PRIMARY OBJECTIVE OF YOUR ORGANISATION?




Contact Details:
Contact Name:                               Position within organisation:


Contact E-mail address :



Contact Mobile Phone Number:



                                                                                             P a g e |5
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application



DOES YOUR GROUP REPRESENT A PARTICULAR CULTURAL OR ETHNIC GROUP?

Tick/specify one only

   English
   Irish
   Scottish
   Italian
   Greek
   Chinese
Other – please specify ____________________




City of Monash Bulletin

The Monash Bulletin is published every four weeks, to coincide with the cycle of
Council meetings. It features news, service information and events. The Monash
Bulletin is available in Chinese, English, Greek or Italian. If your group would like to
receive the Monash Bulletin please indicate below how many copies you would like
posted to your group.



Language          Number of
                  Copies
Chinese
English
Greek
Italian




                                                                                P a g e |6
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application


SECTION 6: PROJECT SUMMARY


Service Area:
                          Tick one box only:
                               Aged - Senior Citizens
                               Aged – Probus Club
                               Aged – Other Category
                               Disability Services
                               Neighbourhood Houses
                               Children's Services
                               Counselling & Community Support
                               Multicultural
                               Youth
                               Community Strengthening & Participation
                               Arts & Cultural Projects
                               Community Festivals and Events
                               Local Emerging Artists



Project/Service/Event Title:



Brief description (30 words):




SECTION 7: CASH FUNDING REQUEST



2013 Cash request                                      $
2014 Cash request (where eligible)                     $

2015 Cash request (where eligible)                     $




                                                                          P a g e |7
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application


SECTION 8: WHAT ARE YOU GOING TO DO?




SECTION 9: WHY ARE YOU DOING THIS?




                                                                P a g e |8
            2013 Monash Community Grants Program
Community Support, Hall Hire Booking and Printing Funding Application

SECTION 10: WHO WILL BENEFIT?




SECTION 11: HOW WILL YOU SPEND THE FUNDS IF SUCCESSFUL?




                                                               P a g e |9
            2013 Monash Community Grants Program
Community Support, Hall Hire Booking and Printing Funding Application

SECTION 12: HOW WILL YOU KNOW IF YOUR PROJECT HAS BEEN SUCCESSFUL?




                                                              P a g e | 10
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application

SECTION 13: FACILITY HIRE FACT SHEET

Below is a list of the facilities that may be requested to be used by community groups through
the Monash Community Grants Program. Before you fill in the application form to apply for a
venue we request that you make contact with the venue manager to make sure that the
venue meets your needs and to check its availability. The contact details for the City of
Monash venues are listed below. When completing the application for hall space please
endeavour to provide definite dates, as due to increased use of Council’s community
buildings changes may not be possible.

                Please note that some venues may only be available for ad-hoc use

                                                          Available      Available   Monash            Phone
Facility name                  Address
                                                            days          times      Department        number
                                                   ASHWOOD

                               21a Electra Avenue,                                   Monash
Ashwood Hall                   Ashwood                          Daily    9am-11pm    Halls          9518 3684
                                                                                     Electra
                               21a Electra Avenue,                                   Community
Electra Community Centre       Ashwood                          Daily                Centre         9807 6502


                                                   BURWOOD

                                                                           9am-      Recreation
Gardiners (North) Pavilion     6th Avenue, Burwood             Mon-Fri    3.30pm     Services       9518 3583


                                                   CHADSTONE
                                                                                     Amaroo
Amaroo Neighbourhood           34 Amaroo Street,                                     N/hood
House                          Chadstone                                             House          9807 0570
                                                                                     Batesford
                                                                                     Hub
Batesford Community Hub        Batesford Road, Chadstone                             Coordinator    9832 5800
                                                                                     Jordanville
                               Batesford Reserve,                                    Community
Jordanville Community Centre   Batesford Road, Chadstone                             Centre         9807 0570


                                                     CLAYTON
                                                                                     Clayton
Clayton Community Centre                                                             Community
(meeting rooms & theatrette)   Cooke Street Clayton             Daily                Centre         9541 3130

                                                                                     Monash
Clayton Hall                   264 Clayton Road, Clayton        Daily    9am-11pm    Halls          9518 3684

                                                                                              P a g e | 11
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application


                                                                Available   Available    Monash       Phone
Facility name                    Address
                                                                  days       times      Department    number

                                                      CLAYTON

                                                                                        Monash
Clayton Senior Citizens Centre   19 Mary Street, Clayton          Daily     9am-11pm    Halls          9518 3684

                                                                                        Monash
Fregon Hall                      Fregon Road, Clayton             Daily     9am-11pm    Halls          9518 3684

                                 356a Haughton Road,                          9am-      Recreation
Meade Pavillion                  Clayton                         Mon-Fri     3.30pm     Services       9518 3583

                                              CLAYTON NORTH

                                 72 Clayton Road, North                                 Monash
Monash Community Inn             Clayton 3168                     Daily     9am-11pm    Halls          9518 3684

                                                GLEN WAVERLEY
Glen Waverley Community          700 Waverley Road,                                     Monash
Centre                           Glen Waverley                    Daily     9am-11pm    Halls          9518 3684
                                 5-11 Madeline Street,                         9am-     Recreation
Glen Waverley North Pavillion    Glen Waverley                   Mon-Fri      3.30pm    Services       9518 3583
                                                                Weekday     8.15am -
                                                                            10pm        Kerrie
                                                                Weekend                 N/hood         9887 6226
                                 36 Kincumber Drive,            Saturday  8am-5pm       House
Kerrie Neighbourhood House       Glen Waverley                  Sundays   9am-5pm
                                                                Weekends
                                                                 & school 9am-10pm
                                                                 holidays
                                                                                        Mount
                                                                Phone for               Street         9803 8706
                                                                Weekday                 N/hood
Mount Street Neighbourhood       6 Mount Street,                  avail-                House
House                            Glen Waverley 3150              ability
                                 996 High Street Road,                        9am-      Recreation
Napier Park                      Glen Waverley                   Mon-Fri     3.30pm     Services       9518 3583


                                                    HUGHESDALE
                                 cnr Poath Road &
Hughesdale Community             Kangaroo Roads,                                        Monash
Centre                           Hughesdale                       Daily     9am-11pm    Halls          9518 3684




                                                                                                 P a g e | 12
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application

                                                                 Available    Available    Monash           Phone
 Facility name                   Address
                                                                   days        times      Department        number

                                                   HUNTINGDALE
                                cnr Germain Street &
                                Huntingdale Roads,                                        Monash
Huntingdale Hall                Huntingdale                       Daily      9am-11pm     Halls            9518 3684

                                                  MOUNT WAVERLEY
                                cnr High Street Road &                                    Monash
Alvie Hall                      Alvie Roads, Mt Waverley          Daily      9am-11pm     Halls            9518 3684
Mount Waverley Community        47 Miller Crescent,                                       Monash
Centre                          Mount Waverley                    Daily      9am-11pm     Halls            9518 3684
                                8-26 Charles Street,                           9am-       Recreation
Mount Waverley Pavillion        Mount Waverley                   Mon-Fri      3.30pm      Services         9518 3583
                                45 Miller Crescent,                                       Monash
Mount Waverley Youth Centre     Mount Waverley                    Daily      9am-11pm     Halls            9518 3684
                                                                                          Waverley
                                                                                          Community
Waverley Community Learning     5 Fleet Street,                                           Learning
Centre                          Mt Waverley                                               Centre           9807 6011

                                                      MULGRAVE
                                355 Wellington Road,                                      Monash
Mulgrave Community Centre       Mulgrave                          Daily      9am-11pm     Halls            9518 3684
                                                                                          Mulgrave
Wellington Reserve              36-42 Mackie Road,                                        N/hood
Community Centre                Mulgrave                          Daily                   House            9548 3311

                                                   NOTTING HILL
                                                                                          Nottinghill
Nottinghill Neighbourhood       37 Westerfield Drive,                                     N/hood
House                           Nottinghill                       Daily      9am-10pm     House            9561 0114

                                                      OAKLEIGH
Monash Seminar & Training       1A Atherton Road,                                         Monash
Centre                          Oakleigh                         Mon-Fri     9am-5pm      Halls            9518 3684
                                40 Haughton Road,                                         Monash
Oakleigh Community Centre       Oakleigh                          Daily      9am-11pm     Halls            9518 3684
                                142-144 Drummond St,                                      Monash
Oakleigh Hall                   Oakleigh                          Daily      9am-11pm     Halls            9518 3684
                                                                              10am-
Oakleigh Library- Oakleigh      148 Drummond Street,                                      Oakleigh
                                                                 Mon-Fri      3.30pm                       9563 4138
Auditorium                      Oakleigh                                                  Library
                                                                  Sat        9am-4pm
Oakleigh Senior Citizens        146 Drummond Street,                                      Monash
Centre                          Oakleigh                         Mon-Fri     9am-11pm     Halls            9518 3684
                                1658-1660 Dandenong Rd,                        9am-       Recreation
Princes Highway West Pavilion   Oakleigh East                    Mon-Fri      3.30pm      Services         9518 3583

                                                                                                     P a g e | 13
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application

                                                             Available   Available    Monash           Phone
Facility name                  Address
                                                               days       times      Department        number

                                                  WHEELERS HILL

                                                                                     Monash
Monash Gallery of Art (Ramp    Cnr Jells & Ferntree Gully     Tue-Fri    10am-5pm    Gallery of         8544 0500
Gallery & Breezeway Gallery)   Rds, Wheelers Hill
                                                                                     Art
                                                             Sat-Sun     12pm-5pm
Waverley Women's Softball      2-30 Jells Road,                            9am-      Recreation
Centre                         Wheelers Hill                 Mon-Fri      3.30pm     Services           9518 3583
                                                                          10am-
Wheelers Hill Library -        860 Ferntree Gully Road,      Mon-Fri      8.30pm     Wheelers
                                                                                                        9561 6211
Meeting Room                   Wheelers Hill                                         Hill Library
                                                                  Sat    9am-4pm




                                                                                                  P a g e | 14
              2013 Monash Community Grants Program
  Community Support, Hall Hire Booking and Printing Funding Application

SECTION 14: HALLS MANAGEMENT VENUES BOOKING REQUEST 2013
                                                                                                                                           Office use only: APP No _________


       Please complete this page and the next page to book and apply for funding for Monash Halls venues:

ORGANISATION NAME                      _________________________________________________________

VENUE NAME               ____________________________________________________________________

TO ENSURE THAT OUR RECORDS ARE ACCURATE, PLEASE FILL IN THE DETAILS BELOW, AND RETURN.

COMPLETE TITLE OF ORGANISATION …………………………………………………………………………………………………………….

PRINCIPAL CONTACT                       Name...................................................................................... Position …………....................................……

Address .....................................................................................................................................…. Postcode...........................................

Phone: Bus. ......................................… Priv. ..............................…. Mobile.............................................… Fax. ...................................

POSTAL ADDRESS
General Correspondence ............................................................................................................................….. Postcode..........................

Invoices .......................................................................................................................................................….. Postcode..........................

PRESIDENT                    Name........................................................................................................................................................................…

Address ....................................................................................................................................................…….. Postcode.........................
          .
Phone: Bus. ..................................… Priv. ..................................…. Mobile..........................................……..Fax. .................................

SECRETARY                    Name.......................................................................................................................................................….

Address ....................................................................................................................................................…….. Postcode.........................

Phone: Bus. ..................................… Priv. ..................................…. Mobile..........................................……..Fax. .................................

TREASURER                    Name........................................................................................................................................................…

Address ....................................................................................................................................................…….. Postcode.........................

Phone: Bus. ..................................… Priv. ..................................…. Mobile..........................................……..Fax. .................................

KEYS HELD
Identification numbers ...........….. .............…                     ................ ............…        ............... ................      ............... ............…

Quantity Held                        .............…. .............…         ................ .............… ............... ................            ............... .............…

Name of Holders                   .................................…. .................................… ..................................... ...............................…
                                                                                                                 Please attach separate sheet if insufficient space.

We prefer to be invoiced:                                  Monthly                                      Quarterly                      Half Yearly                                 Yearly

Public Liability Insurance: Own Policy                            Council Policy Required

                                        *              TO KEEP OUR RECORDS UP TO DATE PLEASE NOTIFY US                                                             *
                                                        OF ANY CHANGES TO THE ABOVE DURING THE YEAR




                                                                                                                                                                                        P a g e | 15
            2013 Monash Community Grants Program
Community Support, Hall Hire Booking and Printing Funding Application
                             REQUIREMENTS FOR 2013
                                                                          NOTES AND
                                        TIMES
                                                          AREA WITHIN       OTHER
MONTH     DAY        DATE             FROM – TO
                                                            VENUE       REQUIREMENTS
                                (INCL SET UP & PACK UP)
                                                                           E.G. PA


 JAN
                                   am / pm – am / pm


 FEB
                                   am / pm – am / pm


MAR
                                   am / pm – am / pm


 APR
                                   am / pm – am / pm


 MAY
                                   am / pm – am / pm


 JUN
                                   am / pm – am / pm


 JUL
                                   am / pm – am / pm


 AUG
                                   am / pm – am / pm


 SEP
                                   am / pm – am / pm


 OCT
                                   am / pm – am / pm


 NOV
                                   am / pm – am / pm


 DEC
                                   am / pm – am / pm

        * PLEASE BE SPECIFIC REGARDING THE INFORMATION FOR EACH DAY / DATE. *
                      AVERAGE NUMBER OF PERSONS ATTENDING AT ANY ONE TIME _____________




                                                                             P a g e | 16
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application

 SECTION 15: OTHER COUNCIL FACILITY HIRE REQUEST

Please complete this section to book and apply for funding for council venues other than Monash
Halls venues:


If you wish to hire or rent another Council facility and you wish to apply for in kind support,
please provide the following information: eg Neighbourhood Houses, Sports Pavilions

Name and Address of Facility:______________________________________

_____________________________________________________________

Frequency of use:_______________________________________________

Day(s) of use:__________________________________________________

Total Cost for 2013:_____________________________________________
You are required to contact the venue manager to obtain this cost.

Is there a lease / licence / facility agreement with Council?…………..Yes/No

If yes, what is the expiry date? ___________________________



SECTION 16: PRINTING REQUEST

*Please refer to the attached guidelines BEFORE filling out details below

How many A4 copies do you wish to apply for in 2013? __________________

NOTE – For double sided copies, please count this in the total as 2 copies:
                    fgh
                    jdf
                    ghs
                    dfg
                    asd
                    fgs
                    dfg
                                         1 sided = 1 copy
                    hjk
                    dfg
                    hj




                    dfg        ert
                    hjc        yu
                    vbx        cd



                          +              Double Sided (Front & Back) = 2 copies
                    cvb        vb
                    xcv        xc
                    bxc        vb
                    vbc        cv
                    vbv        bc
                    b          vb
                               vb




Please note:
Copies can only be black ink on white A4 80gsm paper.
Coloured paper for front and/or back cover can be provided upon request
A minimum of 5 working days notice is required for all print jobs




                                                                                        P a g e | 17
             2013 Monash Community Grants Program
 Community Support, Hall Hire Booking and Printing Funding Application

SECTION 17: FINANCIAL & LEGAL DOCUMENTATION

Please attach copies of the following

       Certificate of Incorporation or other evidence of legal status.
       Latest Audited Financial Statement or Treasurers Report.
       Current Public Liability Insurance Policy/Certificate
       A copy of the Statement by a Supplier form where an organisation does not have an
        ABN
       A draft of the Risk Management Plan (applies only for Community Festivals & Events)

SECTION 18: LOCAL EMERGING ARTIST FINANCIAL & LEGAL DOCUMENTATION

Please attach copies of the following

       A brief one page CV relevant to Arts experience
       Proof of Australian Residency
       Proof of identity including current address
       Letter from venue confirming hire/rent details (where applicable)
       Enclose any relevant support material with your application.
       A copy of the ‘Statement by Supplier’ form where an artist does not have an ABN

SECTION 19: CERTIFICATION
To be signed by the chair or the Chief Executive of the organisation.

       I certify that to the best of my knowledge the statements made in this application are
        true.
       I understand that if the Monash City Council approves funding for the requested
        project, I will be required to accept the conditions of funding as outlined in the Funding
        Deed or Agreement.
       I consent to the information contained within this application being disclosed to or by
        Monash City Council for the purpose of assessing, administering and monitoring my
        current and any future Monash City Council funding applications.
       I consent to be on a mailing list for the use by Monash City Council to promote other
        Council opportunities, programs and services.

       Name                                             Position in organisation


       Signature                                        Date



                                                                                        P a g e | 18

								
To top