For Official Use Only
Grants to Voluntary Environment, Sustainability
and Heritage Organisations (GVESHO) 2013-14
This proposal must be completed by the organisation that is a legal entity able to enter into a funding agreement with the Australian
Government – the ‘applicant organisation’ is the legal entity.
Completing this form
Please read the GVESHO 2013-14 Guide carefully before completing this application form as it contains important information on
eligibility requirements and details on how to complete and submit your application. Other useful information, including Frequently
Asked Questions, is available at http://www.environment.gov.au/about/programs/gvesho/.
Please complete your application with reference to the GVESHO 2013-14 Guide.
To obtain a hard copy application form please contact the Department. Please do not print this document and complete by hand.
Essential information will not be available in this format.
To enable web links to retrieve information automatically we recommend that you are connected to the internet when filling out the
application.
You should confirm your ABN (in the Applicant details section), before proceeding with other data entry.
Note that the eligibility requirements are mandatory. If your organisation does not meet these requirements, please do not submit an
application.
ALL QUESTIONS MARKED WITH AN (*) MUST BE COMPLETED FOR YOUR APPLICATION TO BE ASSESSED
Before you start your application, the following questions will assist in determining your eligibility.
Is the organisation a Government organisation/agency? *
Yes
No
Is the organisation’s principal purpose and/or activity political advocacy? *
Yes
No
Did the organisations have revenue exceeding $5 million for the last completed financial year? *
Yes
No
Answering ‘Yes' to the above question(s) may render you ineligible for funding through this program. Please refer to the guidelines.
Does the organisation have a minimum voting and financial membership of 50; or a minimum membership of 5
affiliated bodies with an aggregate membership of 200; or in the case of a trust, demonstrate strong community
support? *
Yes
No
Does the organisation prepare annual, audited financial statements? *
Yes
No
Supporting documentation should be attached at the end of this application form and labelled as Financial Statements
Is the organisation not-for-profit? *
Yes
No
Yes
No
Supporting documentation should be attached at the end of this application form and labelled as Not-for-profit
Can the organisation provide a copy of the certificate of incorporation or deed of trust? *
Supporting documentation should be attached at the end of this application form and labelled as Certificate of Incorporation/Deed of
Trust
Answering ‘No' to the above question(s) may render you ineligible for funding through this program. Please refer to the guidelines.
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Applicant details
Confirm the organisation’s ABN before proceeding beyond this page. If you do not, you may lose data that has not previously been
saved.
Name and details of organisation
Is the applicant entity applying for funding in its capacity as a trustee of a trust? *
Yes
No
If answered yes, applicant details provided below must be those of the trustee (i.e. not the trust).
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ABN Details
Does the applicant organisation have an Australian Business Number (ABN)? *
Yes
No
The applicant must be a legal entity able to enter into a funding agreement with the Australian Government.
Additional information can be found in the guidelines.
If you do not hold a current ABN, you will be required to complete a ‘Statement by a Supplier’ form (available from the Australian
Taxation Office) before entering into any funding agreement with the Australian Government.
Australian Business Number (ABN) *
Legal name *
This is the name that appears on all official documents and legal papers. It may be different to your organisation’s trading name.
Trading name *
Entity type *
Is the organisation Incorporated? *
Yes
Incorporation number *
Incorporation date *
Is the organisation GST registered? *
Yes
No
No
Purpose, objective or mission statement of your organisation: *
Limit your response to no more than 250 characters max (approx 40 words).
Is the organisation a: *
National body
State body
Regional body
Local body
Organisational Address
Postal address of organisation
Is this address a PO Box or Locked Bag?
Street number *
Street name *
Street Type *
Suburb/Town *
State *
Postcode *
Email
Website
Street address of organisation
Is the street address the same as the postal address? *
Yes
No
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Street number *
Street name *
Street Type *
Suburb/Town *
State *
Postcode *
Authorised person details
Note: This is the person within the applicant organisation who is authorised to sign the funding agreement with the Australian
Government. In the case of a trust, nominate the name of the trustee.
Title: *
Mr
Mrs
Miss
Ms
Dr
First name *
Other
Last name *
Position in organisation
Phone (business hours) *
Phone (mobile)
Facsimile
Email
Contact person
Is this contact person the same as the one above? *
Yes
No
Preferred Contact
Title: *
Mr
Mrs
Miss
Ms
First name *
Dr
Other
Last name *
Position in organisation
Phone (business hours) *
Phone (mobile)
Facsimile
Email
Details of office bearers
President / Chair / CEO: *
Vice President / Deputy Chair: *
Treasurer: *
Secretary: *
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Trustee
Delete
Add trustee
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General eligibility requirements
Membership information
Is your organisation:
Made up of at least 50 individual financial members, with voting rights? *
Yes
No
Yes
No
Number of members: *
Minimum membership of 5 affiliated bodies with an aggregate membership of 200. *
If the organisation’s membership is comprised, in whole or part, of affiliated bodies, the name, address and membership numbers of
each of these bodies is to be provided in an attachment at the end of this application form labelled Affiliated Body
A trust, with strong community support? *
Yes
No
Detail the level of this support below, including information on community involvement together with membership and volunteer
activity. *
Limit your response to no more than 1000 characters max (approx 150 words).
Program Priorities
Select the organisations principle objective/s. *
To provide for the protection of the environment, especially those aspects of the environment that are matters of national
environmental significance.
To promote ecologically sustainable development through the conservation and ecologically sustainable use of natural resources.
To promote the conservation of biodiversity.
To provide for the protection and conservation of heritage.
To promote a co-operative approach to the protection and management of the environment involving governments, the
community, land-holders and indigenous peoples.
To assist in the co-operative implementation of Australia’s international environment responsibilities.
To recognise the role of Indigenous people in the conservation and ecologically sustainable use of Australia’s biodiversity.
To promote the use of Indigenous peoples’ knowledge of biodiversity with the involvement of, and in co-operation with, the owners
of the knowledge.
To support decision-making processes that effectively integrate both long-term and short-term economic, environmental, social
and equitable considerations.
To ensure that the conservation of biological diversity and ecological integrity is a fundamental consideration in decision-making.
To promote improved valuation, pricing and incentive mechanisms to support the principles of ecologically sustainable
development.
To support the principle of inter-generational equity – that the present generation should ensure that the health, diversity and
productivity of the environment is maintained or enhanced for the benefit of future generations.
Supporting documentation that supports your organisations principle objective should be attached at the end of this application form
and labelled as Objective
Track record of achievement
Demonstrate how your organisation has been effective in meeting these objectives by providing information on significant outcomes that
the organisation has achieved/delivered over the past three (3) years. *
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Limit your response to no more than 2000 characters max (approx 300 words).
Track record of community involvement
Demonstrate your organisations record of community involvement over the past three (3) years. *
Limit your response to no more than 2000 characters max (approx 300 words).
3
Current activities and the program priorities
Protecting endangered and threatened native species, including protecting and restoring the habitat of these species, threatened
ecological communities and migratory species.
Reversing the long-term decline in the extent and quality of Australia’s native vegetation.
Protecting and restoring significant fresh water, marine and estuarine ecosystems, including improving water quality in coastal,
estuarine and inland waters.
Protection and conservation of water resources other than significant freshwater, marine and estuarine ecosystems.
Assisting in the implementation of Australia’s international environmental responsibilities.
Preventing or controlling the introduction and spread of feral animals, aquatic pests, weeds and other biological threats to
biodiversity.
Protection, conservation or rehabilitation of the natural environment and ecosystems, including waste management or protected
area management.
Reducing or offsetting greenhouse gas emissions.
Taking an integrated approach that considers the three dimensions of sustainability - environmental, social and economic.
Promoting resilience to future changes – for e.g. climate, population, economic.
Promoting an innovative approach to improving sustainability, for e.g. through education, research and/or training.
Contributing to behaviour change and/or a better understanding of sustainable practices.
Conservation of places of historic significance.
Promotion of Australia’s historic heritage including education, research and training.
Protecting Australia’s moveable historic heritage.
Recognising the role of Indigenous people in the conservation and ecologically sustainable use of Australia’s biodiversity.
Promoting the use of Indigenous peoples’ knowledge of biodiversity with the involvement of, and in co-operation with, the owners
of the knowledge.
Other – You must provide supporting evidence for the justification of these activities
Supporting evidence
Briefly outline below information on how the organisation intends to engage in and/or support natural environmental conservation and/or
enhancement activities. *
Limit your response to no more than 2000 characters max (approx 300 words).
Do you wish to supply any supporting documentation? *
Yes
No
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Supporting documentation should be attached at the end of this application form and labelled as Current Activities
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Geographic funding priorities
Which of the following funding priorities does your organisation fall into? *
National environment organisation with large membership; a broad coverage of a wide range issues relating to the Program
Priorities; an acknowledged leadership role; the capacity to provide effective support and policy development or to undertake or
coordinate on-ground improvement and/or conservation activities; or an organisation whose activities relate to heritage of
national significance.
State or Territory organisation that has a broad focus covering a number of issues across the state/territory; are representative
of a broad range of groups from across the state/territory; are a resource centre for community action across the state/territory;
demonstrate effectiveness in relation to the organisation’s objectives; have a high level of community support and participation;
or an organisation whose activities relate to heritage of national significance.
Regional organisation that have a broad focus covering a number of issues across the region; are representative of a broad
range of groups from across the region; acknowledged as a resource centre for community action across the region;
demonstrate a high level of community participation; have demonstrated effectiveness in relation to the organisation’s
objectives; or an organisation whose activities relate to heritage of national significance.
Local organisations with a track record of information; on-ground activity; education; research and/or training; and a relative
degree of community support.
Outline the basis for the organisations’ claim that it meets one of the nominated funding priority categories. *
Limit your response to no more than 2000 characters max (approx 300 words).
5
Total administration budget of organisation
Please provide estimates of the total costs that are expected by your organisation this financial year 2013-14. Include all
administrative expenses GST Exclusive.
Activities that will not be undertaken should contain a zero (0) rather than being left blank.
Activity
Details
Estimated cost $
Administrative salaries & on costs
(identify position & salary)
Accommodation (rent only - do not
include mortgage repayments)
Office expenses including utility
charges
Office equipment
Travel, domestic or international
(please specify)
Training
Other
Delete
Total estimated administrative cost:
$0
Add other activity
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GVESHO Funding
Administration and/or Capital item funding request
Grants will be offered for administrative assistance. Capital Funding allocations will be incorporated into the total grant amount received
by successful organisations for capital items that will assist with the ongoing operation of your organisation.
Identify how much support is being sought through the GVESHO Program for the 2013-14 financial year. If you are applying for multiyear funding for 2013-14, 2014-05 and 2015-16, please enter amounts under those years.
Is organisation applying for multi-year funding for 2013-14, 2014-05 and 2015-16 *
Yes
No
Is organisation applying for capital item assistance? *
Yes
No
Administrative and/or capital item
assistance requested
$ (GST exclusive)
$ (GST inclusive)
2013-14 ($)
$0.00
2014-15 ($)
$0.00
2015-16 ($)
$0.00
Total estimated administrative funding
requested
$0.00
$0.00
Administrative assistance - explain how the requested funds will assist to meet the administration costs of the organisation. For
example, they might be spent on administrative staff salaries, utilities and office rental. *
Limit your response to no more than 2000 characters max (approx 300 words).
Multi-year funding - Applicants for multi-year funding are expected to be a well-established group with a long track record of
significant environmental or heritage outcomes and considerable experience in managing government grants. Provide details of why
multi-year funding is necessary for your organisation. *
Limit your response to no more than 2000 characters max (approx 300 words).
Capital item assistance – list the capital items you wish to purchase, the full purchase price and the amount of assistance requested.
Note at best 50 per cent of full cost may be provided. *
Please provide information as to the benefits/necessity of each capital item for your organisation.
Limit your response to no more than 1000 characters max (approx 150 words).
Copies of quotes capital items are required and should be attached at the end of this application form labelled as Capital Item Quotes
Please Note: As funding for this program is highly competitive, it is unlikely that you will be awarded funds to the total
amount that you have requested.
Funds approved may be used on any of the items identified in the ‘GVESHO Funding, Administration and/or Capital item
funding request’ Section, or the ‘Total estimated administration budget of organisation’ Section of this application unless
otherwise specified in the funding agreement, that is, where an ineligible item has been identified.
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All grants received over the last 5 years
Information on all grants received form the Australian Government and all other sources (i.e. not just GVESHO or Department of the
Sustainably, Environment, Water, Population and Communities programs) by the organisation over the last 5 years should be provided.
This includes the following financial years: 2008-09, 2009-10, 2010-11, 2011-12 and 2012-13.
When filling out this section, applicants should identify the name of the Department or authority issuing the grant, the program, the
purpose of the grant and the amount (GST exclusive).
Name of Department or
Agency
Name of Program
Purpose
Financial Year
Amount (GST
exclusive)
Delete
Add Grant
Other grants being sought
Information on all grants that have been and/or will be applied for is required.
If you are applying for multi year funding provide details for all three financial years (2013-14, 2014-15, 2015-16). Otherwise, only details
for 2013-14 are required.
When completing this section you should identify the Department/Authority issuing the grant, the grant program, the financial year and
amount of funding (GST exclusive).
Name of Department/Authority
Name of Program
Financial Year
Amount (GST
exclusive)
Delete
Add Grant
Other sources of income
Include details of income from trusts, membership fees, donations, etc.
Name of Source eg membership fees, donations etc
Financial Year
Amount (GST exclusive)
Delete
Add other source of income
Applicant conflict of interest
Applicants are required to advise the Department in writing where any actual, apparent or potential conflict of interest exists in
relation to their application that may impact on it, or any funding agreement it may enter into with the Department.
Is there any actual, apparent or potential conflict of interest in relation to your application? *
Yes
No
Written declaration detailing the conflict of interest must be provided to the department as an attachment at the end of this application
form labelled as Conflict of Interest
7
Declaration and submission
You may attach documentation to this form to support your application. Please use the ‘Add’ button to browse your local computer and
attach your chosen files. Each file can be up to 2 MegaBytes in size.
Document Name
Objective
Financial Statements
Document
Type
.pdf, .jpg,
.docx, .doc,
.zip
.pdf, .jpg,
.docx, .doc,
.zip
Req'd
Filename
File Size
(KB)
Yes
0
Yes
0
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Document Name
Not-for-profit
Certificate of Incorporation/Deed of
Trust
Affiliated Body
Current Activities
Capital Item Quotes
Conflict of Interest
Document
Type
.pdf, .jpg,
.docx, .doc,
.zip
.pdf, .jpg,
.docx, .doc,
.zip
.pdf, .jpg,
.docx, .doc,
.zip
.pdf, .jpg,
.docx, .doc,
.zip
.pdf, .jpg,
.docx, .doc,
.zip
.pdf, .jpg,
.docx, .doc,
.zip
Req'd
Filename
File Size
(KB)
Yes
0
Yes
0
Yes
0
Yes
0
Yes
0
Yes
0
Total file size (MB):
0
Declaration
I, the undersigned, certify that:
I have completed all questions in this application in consultation with the GVESHO 2013-14 Guide; and
The information contained in this application and its supporting material is true and correct to the best of my knowledge; and
I understand that providing false or misleading information is a serious offence under the Criminal Code Act 1995 (Cth) section
137.1; and
I understand that the information provided in this application may be disclosed to various parties as described within the GVESHO
2013-14 Guide; and
I acknowledge that my application will not be accepted if it is late, faxed or incomplete, including not having all required supporting
material attached; and
I have the approval and authority of my organisation in submitting this application.
Date *
Full Name *
Position in Organisation *
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