Regional Grants 2015 Application for Funding Organisation details (or sponsoring organisation details) Funds are only provided to non-Government organisations and/or not-for-profit organisations. Name and Postal address of the organisation and/or auspice organisation: include ABN ABN: Telephone number: E-mail address: (required for receipt notification) Event Organising Committee Details: You must actively include and involve at least 5 organisations (both non-govt & government) who work with children, young people, parents, carers and families as part of the event planning committee Member Name Organisation Email Address Identify Event Region: ______________________________ Far North Queensland Region North Queensland Region Central Queensland Region North Coast Region South East Region South West Region Phone Does your organisation hold appropriate insurance? Please ensure that your public liability insurance covers the proposed event. Please specify the type of insurance cover held: Insurance Policy Details: (attach copy of current certificate) Overview of Regional Event: This section must be completed in 1,000 words or less. Your Regional application will be judged against the following key criteria. Be sure to use these criteria as headings in your proposal and refer to the guidelines. 1. Date of proposed events or activity 2. Location include address of proposed event 3. Description of the proposed activity, include estimated number of attendees. Please write a statement to explain how your project will reflect the aims and theme of Child Protection Week 2015 in your local community. 4. Promotion: outline how both the activity and Child Protection Week will be promoted, and to whom (eg. brochures, posters, media etc). Proposed Budget - Grants of up to $3000 (inclusive of GST) are available: Please provide banking details for payment processing: BSB: Account Number: Account Name: Please provide itemised breakdown of anticipated costs: Item Total Funding requested Amount $ This document is a Tax Invoice. ACT for Kids (ABN 4705 1964 673) auspice body for the Queensland Child Protection Week Committee Amount: $3000.00 (inclusive GST) subject to funding approval. To be eligible for funding your submission must respond to the selection criteria outlined below.       Facilitate a regional event that promotes the theme Protecting Children is Everybody’s Business and reflects the interests and diversity of the region; The event/activity must be completed within Child Protection Week 6-12 September 2015. In exceptional circumstances, applications for event/activities in the week prior to Child Protection Week will be considered. raise awareness of child abuse and neglect as an issue within local Australian communities promote local services available to support children and families who have experienced child abuse and neglect, or are at risk equip individuals and communities with knowledge and skills to understand child abuse and neglect and empower them to take action Funding submissions must reflect collaboration with other agencies within the region (minimum 5 organisations required) Application due date Monday 20 May 2015 I/we declare that the information provided here is, to the best of our knowledge, accurate and complete. I/We agree to abide by the conditions of funding laid out in the application form and understand that I/we will be responsible for completing an accountability of expenditure report within one month of the completion of the activity. Name and Title Auspice Organisation Signed: ______________________________ Date Date: __________________ 7. Lodging the Application Form Applications must be received by close of business Monday 20 May 2015. No late applications will be accepted. The application may be submitted via email only. Please send completed forms to: [email protected] Applicants will be notified of receipt of application via email and outcomes of the submission early July 2015. For assistance in completing your application contact the Child Protection Week Project Officer, Caitlin King on 0418408062. For examples of previous regional events visit www.childprotectionweek.org.au Acquittal Process: The acquittal statement must be completed and returned by the due date of 2 October 2015. Future funding will not be considered if this process is not completed.