Towong Community Bushfire Disaster Relief Fund
Grant Application

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SECTION ONE

PROJECT
ORGANISATION DETAILS
LOCATION ADDRESS
MAIL ADDRESS
Does your organisation have:


Please provide a copy of endorsements if available.
HEAD OF ORGANISATION (CEO or equivalent)
PROJECT MANAGER (if different to Head of Organisation)
AMOUNT REQUESTED

Please enter without any symbols (eg. $)
Please note: This grant round is targeting applications up to $50,000.
FINANCIAL INFORMATION



Auditor or treasurer's details
COMMITTEE OR DEPARTMENT MANAGEMENT (Office Bearers Only)
STAFFING RESPONSIBLE FOR THIS PROJECT
LOCATION INFORMATION

REFEREE
Please proved the name and contact details of an external referee who knows your organisation well and who would be prepared to support your application. Letters of support from this person and others you have consulted with can be uploaded in Section 2.
FUNDING
Please provide details of any other funding for this project. Click on the Add another funding source link to add additional funding bodies.
Please enter without any symbols (eg. $)


SECTION TWO

PROJECT DETAILS










SECTION THREE

DECLARATION
The signatory below is HEAD OF THE ORGANISATION (CEO or equivalent) and has been authorised to seek funding on its behalf.

I HEREBY CONFIRM THAT all details contained in this Application (Section 1 and Section 2) are a true reflection of the status of our organisation and the project that we wish to undertake.
Head of organisation - CEO or equivalent.
Please note that your application may take a while to submit, particularly if you have attached large files. Please do not navigate away from this page until you see the confirmation screen.
CHECKLIST FOR COMPLETION OF FULL APPLICATION