Form

Peter Lehmann Arts & Education Trust Scholarship and Grant Application Form

Application Deadline - October 31, 2018
Read and follow the instructions carefully prior to submitting your application.

Please read the eligibility criteria for the PLAET prior to sumitting your application.

All terms and conditions regarding PLAET funding can be found on the Foundation Barossa website.

All applicants will be notified whether or not you have been shortlisted on or before the 15th November, 2018.

Applicants must be available for interview during the last week of November or first week of December.
PLAET does not fund your submission, they fund the work that you will be doing.

This submission is the tool you use to describe that work.

The advisory panel wants to see clear information presented in a concise and easy to understand way with convincing evidence to back up your submission. Facts – presented in plain English – are what is required to create a favourable impression.

Before you get to the step of writing an actual submission, you need to plan your project and know it well enough to be able to describe it in a clear and concise way.

If selected, you will be asked to support the data you provide. Each grant or project type may require different information or have different requirements for selection. Likewise, all correspondence and agreements will be generated from the information submitted below.

If you have any questions about how to complete the application form please contact Foundation Barossa on info@foundationbarossa.org.au
I have read and understood the instructions. *

Yes, I have
I. APPLICANT DETAILS:

Tell us about yourself and your organisation. Please note: individuals and organisations are eligible to apply for PLAET funding.
I am applying on behalf of: *

an individual over the age of 18 an individual under the age of 18 an organisation
Contact person: *

First Name Last Name
Contact No. : *

- Area Code Phone Number
E-mail : *
Where the confirmation will be sent to

Postal Address : *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

PARENT/GUARDIAN DETAILS:

Individuals under the age of 18 applying for a grant or scholarship must provide the details of a parent/guardian.
By signing (typing your legal name) in the space below, you are certifying that:
- you are the guardian/parent of the applicant
- are over the age of 18
- have given permission for the applicant to apply for this scholarship
- you have assisted the person completing this application
- all information is correct
When you press the submit button, you will receive an email confirmation that this application was received. Please print for your records and retain as verification of the application.
Parent/Guardian name: *

First Name Last Name
Parent/Guardian contact no. : *

- Area Code Phone Number
Parent/Guardian e-mail : *
Where the confirmation will be sent to
ORGANISATION DETAILS:

If you are applying on behalf of an organisation you must provide the following information regarding your organisation.
Organisation name:
ABN:
Are you or your organisation based within the Barossa region? *

Yes No
Please outline the aims and objectives of your organisation.
Does your organisation have Tax Concession Charity (TCC) endorsement?

Yes No
Please attach a copy of the TCC endorsement from the ATO
Does your organisation have Deductible Gift Recipient (DGR) status?

Yes No
Please attach a copy of the DGR endorsement from the ATO
II. PROJECT INFORMATION
Name of project: *
Your project must come under one of the following categories. It may fit into more than one of these areas. Please choose the one that reflects your project best.
Category of application: *

The Barossa Hill & Son Organ - scholarship or bursary for any activities or projects that will contribute to making the organ an ongoing and vibrant part of Barossa cultural life. Performing and visual arts Emerging artists, artisans and craftspeople sustaining traditional skills associated with Barossa heritage and culture Literary arts, new media, writing and literacy
Project start date

- Day - Month Year
Project end date

- Day - Month Year
DESCRIBE YOUR PROJECT

The following questions will assist you to briefly describe the project or activities proposed. Please answer all questions to the best of your ability. Further information including letters of support or project plans can be attached as pdf or word documents.
BRIEFLY DESCRIBE YOUR PROJECT

You should address: why this project needs to be done, how the idea has come about, who it will help and any evidence to support that.
Project introduction and background (300-500 words). *

If your project has something interesting or ‘outside the box’, try to emphasise that. 0/500
Why is there a need for your project? (max 500 words) *

PLAET supports projects that have tangible results and community benefits. 0/500
How is your project relevant or important to the Barossa? (max 300 words) *

Will it add to the cultural life of the Barossa or showcase the Barossa positively? 0/300
How many people will be involved in the project? (max 300 words) *

Include the names and roles of any key people in your project. How many staff and volunteers are needed for the project? 0/300
Outline the activities that will make your project a success. (max 300 words) *

0/300
How will you determine if the project has been successful and what process or method will you use to evaluate the project? *
Include what you expect will happen as a result of your project and how will you prove that it made a difference?
Are there any other organisations or partners involved in your project? *

Yes No
If you answered yes to the previous question, please outline the involvement of any partners or other organisations.
ADDITIONAL PROJECT INFORMATION.

Further information regarding your project, including project plans, council development or approval documents and letters of support, media clippings or newsletters can be added below.

Each of these documents must be pdf or word documents and cannot exceed 2MB in size.
Project plan, your organisations audited financial reports or approval documentation if applicable.

Upload a File
A maximum of four project documents can be included. Cancel of
Letters of support, media clippings or other documents

Upload a File
A maximum of four supporting documents can be included. Cancel of
III. FINANCIAL INFORMATION
Grant amount requested for this project: *
Use whole dollar amounts. Applicants may apply for between $500 and $5000.
Are you currently receiving or have you previously been awarded a grant or other funding by the PLAET or Foundation Barossa? *

Yes No
Are you currently receiving or have you previously been awarded a grant or funding for this project? *

Yes No
If the project described in this application has received prior funding from PLAET or Foundation Barossa, or is currenlty reciving external funding please outline details including the value of the funding received and its completion date.
If you do not receive a grant from the PLAET will this project go ahead?

Yes No
Please attach a copy of your project budget (excel spreadsheet or word document only).

A project budget is a key item to show that you have planned your project thoroughly and understand the full amount needed to make the project a success.

Include items such as:

Staffing: the number of people and hours, cost of wages, overheads, etc

Materials: cost of materials; will you need to buy or hire any special equipment? Cost?

Facilities: Do you need a venue to carry out the work, or will you need to hire one?

Travel: Does the project involve travel? Do you need to factor in costs such as accommodation, petrol, airfares, meals etc?

Administrative: if these apply, give details of what they may be.

Other costs: Are there things like printing, postage, phone calls or catering involved with the project?
Upload your budget file (word or excel files only)
IV. Applicant's E-Signature
I declare that:

I am authorised to seek funding on behalf of the Person/Organisation named in this application, the information given on this form is complete and correct and no relevant information has been withheld.
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature of applicant: *
E-Signature of parent/guardian: *
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Peter Lehmann Arts & Education Trust Scholarship and Grant Application Form

I. APPLICANT DETAILS:

PARENT/GUARDIAN DETAILS:

ORGANISATION DETAILS:

II. PROJECT INFORMATION

III. FINANCIAL INFORMATION

IV. Applicant's E-Signature