“This funding has been made available under the Bushfire Community Resilience and Recovery Fund”

Hawkesbury City Council is offering communities impacted by the 2019-2020 Summer bushfires grants of between $500 and $5000 (subject to application and funding availability)

Is the organisation a not-for-profit incorporated association?

• Yes
• No

If yes, please attach your Certificate of Incorporation (Only JPG and PDF file types are accepted and file size must not exceed 4MB)

Is the organisation a registered organisation with ABN?

• Yes
• No

If yes, what is your ABN?

Have you arranged for the project to be auspiced by an organisation that is a not-for-profit incorporated association or is a registered organisation with ABN?

• Yes
• No

If yes, please attach a copy of the Memorandum of Understanding with the supporting organisation. (Only JPG and PDF file types are accepted and file size must not exceed 4MB)

Name of organiser

Name of organisation

Nominated contact person

Postal address

Suburb

State

NSWVICQLDWASATASNTACT

Phone

Email

Is your insurance, including a minimum of $10m for public liability insurance, current. Please state the insurance suppliers name and the policy numbers. (Council may request a copy of certificates of currency)

Is the activity based in the Hawkesbury Local Government Area or benefits Hawkesbury residents?

• Yes
• No

Briefly describe the project you are seeking funding for

How will your project benefit the Hawkesbury community?

Indicate start and end dates of the project and any key milestones.

Please fill out the budget template below

Income

Earned Income (from entry fees or sales etc)

Donations (value of gifts or other sponsorship)

Grants (from other government agencies)

Other Income (sundry income)

Contribution (from your organisation)

Amount requested from Council

Total Income

Expenses

Salaries (including volunteer costs)

Promotion, marketing and Advertising

Materials and Program costs

Venue, equipment or transport hire

Childcare

Other costs

Total Expenses

How are you going to measure the success of the project?

Have you received financial support from Resilience NSW for the project in the current financial year?

• Yes
• No

Please attach a copy your most recent audited financial statement. (Only JPG and PDF file types are accepted and file size must not exceed 4MB)

Are you committed to complete a Sponsorship Agreement and a Funding Acquittal form?

• Yes
• No