Page 1

FUNDING APPLICATION FORM

All Questions are compulsory

This application form is for Award Centres and Project Delivery Partners of The Duke of Edinburgh's International Award - Australia who are seeking financial assistance for individuals or groups of young people - who are marginalised, disadvantaged and/or living with a disability - to do their Award. Funding sought can be applied to such costs as Award registration, activity expenses, including Adventurous Journey costs, and staff support/administration.

What type of Application is this?

IndividualGroupPre-approved

Grant Name

Disadvantaged YouthAwards Victoria FoundationSpecial Project

AWARD CENTRE DETAILS

1. Name of Award Centre:

2. Award Centre Street Address:

3. Postcode

5. ABN:

Don't know your ABN? Use this website to help - https://abr.business.gov.au/

Award Leader

6. First Name:

Last Name:

7. Telephone: Daytime office number

8. Email:

9. Are you an existing Award Centre?

YesNo

10.If not a current licensed Award Centre, do you intend to be licenced only if you are successful with this project funding?

Yes

No

11. Brief description for what the funding will be used.

12. Why is it important to have this funding and how will youth in your organisation benefit from doing the Award?

13. Does your organisation deliver any other progams to disadvantaged youth? (i.e. high need or special need) Please provide a summary only. If NO just put NA

14. If you do deliver programs to disadvantaged youth, which of these also include the Duke of Ed?

FUNDING BREAKDOWN

20. Please complete the below table to itemise funding requirements

Please note the below funding guidelines in each part. All Costs are to be GST Inclusive

Registration Support (basic)

Please note:

Registration support cannot exceed the RRP for registrations set by the relevant State/Territory office (Division)

Total Amount Requested

Number of Participants

Average Total Amount per Participant

Is this partial or full Registration Support?

Adventurous Journey (basic)

Please note:

Adventurous Journey funding can be used to hire equipment; it should not be used for the purchase of equipment unless hire options are not available.
Adventurous Journey funding cannot be used for overseas travel. Interstate travel may be considered if local options are not available. Local options are the strong preference.

Total Amount Requested

Number of Participants

Average Total Amount per Participant

What type of expenses will this funding contribute to?

Journey feesEquipmentTravelOther

If other selected, please describe:

How do you intend to deliver the Adventurous Journey?

In House provision (the Award Centre runs the Journeys by itself) A combination of in house and external provider engagement (the Award Centre might use Outdoor education experts to help deliver the Journey)Using an external provider in full (the Award Centre engages an external organisation to deliver the Adventurous Journey with little to no involvement by the Award Leaders)Please select one option only

Other Activity Support/ non-Adventurous Journey (resource)

Please note:

Other Activity Support refers to funding used for activities undertaken as part of the regular Sections of the Award (Voluntary Service, Skills, Physical Recreation) and the Gold Residential Project Section.

Total Amount Requested

Number of Participants

Average Total Amount per Participant

Please select which sections of the Award these other activities will contribute to:

Hold down the 'command' or 'control' key to select multiple values

Please provide a brief description of the activities and explain why this funding is required for these activities.

Staff or Carer Support (resource)

Please note:

Staff Support costs can be claimed for relief staff where and when staff are allocated to accompany Participants for their Adventurous Journey or Gold Residential Project Sections.
Staff Support costs can also be claimed for relief staff where or when staff are required to attend any Award Training run by a State Award Operating Authority.
Carer Support costs can be claimed for carers where Participants have high or additional support needs e.g. social, physical, behavioural, and mental challenges

Total Amount Requested

Number of Participants

Average Total Amount per Participant

Please describe why this funding is required and how it will be allocated.

Intensive Support eg disability (intensive)

Please note:

Intensive Support costs can be claimed where the Participants are high risk or living with profound disability.

Total Amount Requested

Number of Participants

Average Total Amount per Participant

Please describe why this funding is required and how it will be allocated.

Total Amount Requested

Total Number of Participants

Average Total Amount per Participant

21. Please specify any substantial in-kind support that will be provided by your organisation to support your Award Participants.

22. Outline your proposed key activity timetable *

Key Project Timeline

22. b) When do you estimate first activities will commence? Date

22.a) When you estimate Award registrations will commence? Date

22. c) When do you estimate the Adventurous Journey will first take place? Date

22. d) When do you estimate Awards will be completed? Date

23. CHECKLIST

Please ensure you have read all the information at www.dukeofed.com.au/resources/funding-assistance/ before submitting this application.

I have read the Funding Guidelines

I understand this application will be reviewed by the local State or Territory office prior to final approval National Office

I understand I may be required to provide evidence on the eligibility of Participants receiving this funding

I understand that all Participants must be registered with the Award through the Online Record Book (ORB).

I understand that unutilised funds must be returned within 60 days to the National Award Authority

I have attached supporting statement from the Principal of the school or Managing Director from the organisation below. Please note, this statement need not be very long.

Upload your supporting statement here

24. STATEMENT OF AGREEMENT I hereby state that all the information provided on this application is true and accurate. I understand that if successful, the funding provided applies for the Award level for which it was approved and I agree to inform the Award of any changes to these circumstances immediately. On behalf of our school, university, organisation and the Participant(s), I offer a declaration of commitment to the Award and its requirements. In submitting this application I confirm that I or the following senior officer has the authority/delegation to make this submission and ensure the requirements are met.

I Agree

Page 1

FUNDING APPLICATION FORM

All Questions are compulsory

AWARD CENTRE DETAILS

Participant Details

FUNDING BREAKDOWN