Foundation Barossa Community Grants Application Form 2022

Foundation Barossa Community Grants Application Form 2022
Community Grants are given to organisatons and / or community groups that reflect the values and objectives of Foundation Barossa.

Foundation Barossa nurtures and builds our community’s strength and assets. We do this through our own activities and by supporting the activities of service providers and other organisations.

We respond to the challenges and opportunities with the local community to identify key needs, build community strength and find collaborative solutions to problems. This creates a strong, vital community in which everyone can participate and contribute.
Date

Month Day Year
Date
Organisation Name *
ABN *
Contact Name *
Phone Number *

Area Code Phone Number
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal Code
Does your organisation work within the Barossa region? *
Does your organisation have Tax Concession Charity (TCC) endorsement? *
Please attach a copy of the TCC endorsement from the ATO

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Does your organisation have Deductible Gift Recipient (DGR) status? *
Please attach a copy of DGR endorsement from the ATO

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Provide a brief overview of your organisation's main purpose and activities (Max 100 words) *

0/100
Name of Project *
Project Outline (Max 200 words) *

0/200
Who will benefit from your project? *
Why is this project needed? *
Are there any similar services provided by another organisation in the region? If answered yes, please provide details *
Are there any other organisations or partners involved in this project? If yes, please outline their involvement *
How will you determine if the project has been successful and what process or method will you use to evaluate the project? *
Grant Amount requested for Project *
$
Please attach a copy of your project budget *

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Excel spreadsheet or word document only Cancel of
Are you currently receiving or have you previously received a grant or funding for this project from Foundation Barossa?

Yes No
Are you currently receiving or have you previously received a grant or funding for this project from anyone other than Foundation Barossa?

Yes No
If you do not receive a grant from Foundation Barossa will this project go ahead?

Yes No
I declare that I am authorised to seek funding on behalf of the organisation and that any information given on this form is complete and correct and that no relevant information has been withheld *

Yes
Please correct any errors before submitting this form
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Foundation Barossa Community Grants Application Form 2022

Please correct any errors before submitting this form