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									                                COMMUNITY GRANTS PROGRAM

Group Name:         ________________________________________________________________
Group ABN:          ________________________________________________________________
Contact Person:     ________________________________________________________________
Postal Address:     ________________________________________________________________
Email Address:      ________________________________________________________________
Telephone Contact: _______________________Business Hours        _______________________After Hours
                    _______________________Mobile               _______________________Other

The purpose for which Community Grant is sought, including timing for expenditure of grant:

Amount of Grant sought:       $________________ (Grants will be funded to a maximum of $1500)

Has your service, project or event previously received a Community Grant from Council?
    Yes            No         If yes, please specify how much $ _________ and date ___/ ___ / ___

Does the service, project or event receive any other support from Council?
    Yes            No         If yes, please specify _______________________________________

What community benefit will be derived from the service, project or event?

Is there a demonstrated need in the community for the service, project or event?

About Your Group:
Does your Group operate within the Pyrenees Shire?                             Yes           No
Is your group incorporated as a community organisation                         Yes           No
Is your group a non-profit organisation                                        Yes           No

Financial Information:

What contribution can your group provide for this project?

          Cash Contribution                       $________________
          In-kind Contribution Valued at          $________________
          Please attach details of in-kind contribution

Please provide your most recent annual financial report

Have you made or are you going to make an application to any other funding bodies for this project?
    No              Yes          Still under consideration    Amount sourced $________________
If yes, please specify the source(s): ___________________________________________________

I / We agree to abide by the conditions as specified in the Community Grants Policy:
Signed:          _______________________                     Date:       _______________________

Name:            _______________________                     Position:   _______________________


The Community Grants Policy recognises the importance of providing financial assistance to local
community groups to enable them to develop and provide innovative activities, which promote
community participation and wellbeing.

Grants are provided in recognition of the contribution made by community groups and volunteers in
promoting community participation and building stronger communities.

Council makes a yearly budget allocation, which is made available in two funding rounds. Grants
will be to a maximum of $1500.

Funding will only be provided to community organisations which:

           •   Operate within the Shire

           •   Are incorporated as a community organisation

           •   Are a non-profit community group

Projects, services or events, for which funding is sought must:

           1. be located in or provide services to the residents of Pyrenees Shire.

           2. have a clear intent or purpose which, when achieved, will benefit the residents of
              Pyrenees Shire.

           3. not unnecessarily duplicate existing services or activities.

           4. not have been funded in the previous round by Council.

           5. have current public liability insurance which covers the activity.

           6. have an Australian Business Number (ABN) or exemption from the Australian
              Taxation Office.

           7. not be in debt to Council.

Priority will be given to projects, services or events which:

           1. meet an identified community need and there is clear community benefit.

           2. the applicant group contributes to the activity with its own funds and/or in kind

           3. the activity encourages the community group to broaden their role in the community.

           4. have not received a grant in the previous round.

           5. are not already supported by Council

The grant is made subject to acceptance of the following conditions:

           •   A statement along with supporting documentation (eg. receipts) specifying that the
               grant was spent for the purpose for which it was approved must be forwarded to
               Council by 30 June in the financial year the grant was made.

           •   Any unspent funds from the grant as at 30 June must be returned to Council

           •   Acknowledgement of Councils support must be included on all promotional material


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