Application for Financial Assistance

Application Details
Donations to: (Please choose)*
- Organisation
- Individuals
Applicant Name*
First Name Last Name
Organisation Name: (Type N/A if NOT Applicable)*
Phone Number*
Email Address*
Applicant Address*
Street Address Suburb State Post Code
Bank account details

Name of bank account i.e. XYZ Group Inc
Untitled

BSB
Untitled

Account number
Assistance sought:*
- Monetery
- Labour
- Equipment
- Services
- Materials
Other - Please Specify
Value of Assistance: (Note, Maximum is $1,000 organisations and $500 individuals)*
(Up to $5,000 is available for projects with matched funding)
Description of the purpose for which assistance is sought:*
Is the Project identified in the Community Strategic Plan?*
The Community Strategic Plan can be found on this page.
Background/Achievements of individual(s), etc*
Project Start Date*
MM slash DD slash YYYY
Project End Date*
MM slash DD slash YYYY
Role of association in the community: (Type N/A if NOT Applicable)*
How will funds/assistance benefit the community?*
Proposed contribution by applicant*
Is your organisation incorporated or auspiced by an incorporated body?*
Please attach any supporting documents (quotes, letters of support, etc)
Drop files here or

Max. file size: 2 MB.
Note: all successful applicants will be required to lodge an acquittal form (including receipts of purchases) with Council’s Finance Manager within 4 weeks of completion of the project/activity.
Please Complete
Please Acknowledge*
- I acknowledge that I have read and accept the terms and conditions.
Date Signed:*
DD slash MM slash YYYY
Terms and Conditions can be found here.
Application Reference

Application for Financial Assistance

Application Details

Please Complete

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