Methven Community Board Discretionary Grant

Important Note

This form does not automatically save while you are working on it. We strongly recommend you copy and save your answers into a separate word document as you go, to ensure you don’t lose them while working on your application.

Disclaimer
Please check you have read and understood the grant eligibility requirements and funding criteria

The final funding decisions are made at the discretion of The Methven Community Board. Successful applicants’ project details may be used for publicity purposes.

Organisation Details

Organisation Name *

Street Address *

Address Line 2

City *

Organisational Status

Please attach your Charities Commission Number or Certificate of Incorporation if applicable.

Please enter the total amount of funding you require for this project. *

Primary Contact Person

First Name *

Last Name *

Email Address *

Phone (Daytime) *

Organisation Details *

Programme Dates

Start Date *

Day Month Year

Completion Date *

Day Month Year

About your project

Describe your project / programme: *

Why is the project / programme required, and what evidence do you have of this? *

What has been done before? Or what else is happening in the district to address the problem or opportunity? *

Who will mainly benefit from your project / programme? *

What is the main outcome(s) your project / programme will achieve? *

How will you measure your success, and what data will you use? *

Financial Information

Attach Budget outline * Maximum upload size of 10mb

Click here to download the budget document.

Completing your application - To ensure that your application is complete, please check that you have attached the following

A balance sheet from your organisation (Eg. Financial statement) Attach a File

Confirmation of bank account details (Eg. Pre-printed bank slip) Attach a File

What other funding are you applying for, for this event?

Organisation

Amount requested

Date results known

Voluntary Contributions

Briefly describe any voluntary effort, including an estimate of total volunteer hours, and/or donated material contributed towards this project.

What will happen to the event if you do not receive the full amount of the grant you have requested, including how you propose to meet any funding shortfall, if applicable? *

The following must be read and accepted by the Primary Contact Person listed.

I/We hereby declare that the information supplied here on behalf of myself /our organisation, to the best of my/our knowledge, is true and correct and that I/we have the authority to make this application on behalf of our group (if applicable).

I/We hereby declare that we have a Health and Safety Plan in place for the project / programme.

I/We consent to Ashburton District Council collecting the personal contact details provided above, retaining and using these details for the purpose of review of the Community Project Grant. I/We acknowledge my/our right to have access to this information. This consent is given in accordance with the Privacy Act 1993.

I/We understand that my/our project/programme details may be used for promotion of the Community Project Grant and that I/we will be contacted if Ashburton District Council wishes to use these.

I/We understand that the funds received as a result of this application may only be used for the purpose in which they were granted and that a report form with supporting invoices must be submitted to Ashburton District Council on completion of the project / programme.

Terms and conditions

By clicking ACCEPT below, you confirm that you have read and understood and accept the terms set out above. *

First Name

Last Name *

Date *

Day Month Year

You must click "SUBMIT" below for your application to be submitted.

You will receive a confirmation email once your application has been properly submitted. If you do not receive an email, please contact us at grants@adc.govt.nz before applications close.

If you are directed back to the top of the page please scroll down to see what has been missed.