Towong Community Bushfire Disaster Relief Fund
Grant Application (Round 3 - September 2022)

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SECTION ONE

PROJECT
ORGANISATION DETAILS
LOCATION ADDRESS
MAIL ADDRESS
ATO Endorsements: 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. $)
FINANCIAL INFORMATION



Auditor or treasurer's details
COMMITTEE OR DEPARTMENT MANAGEMENT (Office Bearers Only)
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 act as a Referee for your organisation. 
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
All details contained within this Application are a true reflection of the status of our organisation and the project undertaken.

The signatory below is the Head of the Organisation and has been authorised to acquit the project on its behalf.
DECLARED for and on behalf of:
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