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This form is to be used for all grant and loan applications to the Council or Community Boards. Information about grants is found on the Funding page.
* = required fields
Name of organisation/applicant applying for grant *
Contact person *
Residential Address *
Postal Address (if different)
Phone Day *
Phone Night *
Ref#1 Name *
Ref#1 Phone (day) *
Ref#1 Phone (night) *
Ref#2 Phone (day)
Ref#2 Phone (night)
How many members does your organisation serve?
Club sub/levies ($)
Is your organisation a legally constituted society or trust? Yes No
If you are registered for GST, please supply your tax number.Our preferred method of payment is direct credit.
Applications from schools should be approved or submitted by the PTA as a fundraising project rather than an educational project.
Has the PTA and/or Board of Trustees approved this application for funding? Yes No
Purpose of funding * (what these funds will be used for)
Dates of Travel/Event:
Number of persons attending (if group)
Do you require a grant? *
Do you require an advance/loan? *
Total project costs (* - at least ONE required)
(A) Total cost *
Upload copies of your quotes here (* - at least ONE required ). You may upload up to three files, Word or PDF, of up to 5mb each.
Fundraising to date: (* - at least ONE required)
Project Cost and Funding Summary
If you have received any financial assistance from the Selwyn District Council, Local Recreation and Sports Scheme, any Government Department, Lottery Board, QEII Arts Council, Trust or Society in the last three years please give details.
How will this project benefit you/your group, or the Selwyn community? *(max 900 characters)
Are you applying for multiple team members?Please provide names and addresses of members resident in the Selwyn District.(max 900 characters)
Please add anything else you wish that may aid your case for a grant/advance/loan for this project:(max 900 characters)
Optional File Uploads
You may attach up to four files, of up to 2mb in size each, to support your application. Files must be Word, Excel, PDF, text or image format. You may alternatively email your files to email@example.com or post paper copies to the address below.
To assist your organisation in obtaining grant funding, you are welcome to contact any of the Councillors or Malvern Community Board Members. Please refer to Community Board for contact information.
Our preferred method of payment is direct credit. Please provide your bank account number (15 digits) and post or email a deposit slip to the address below.
Bank account number *
Particulars to appear on your bank statement: SELWYN D C
Post/email your deposit form and any other supporting documentation to:
Selwyn District CouncilPO Box 90 ROLLESTON 7643Attention: Stuart Westobyemail: firstname.lastname@example.org
I hereby declare that the above information is correct. If the application is successful, my organisation agrees to provide a certificate (which will be sent to me in due course by the local authority) stating that the money received has been spent or is being held in trust for the purpose stated.
Any enquiries to Stuart Westoby, phone (03) 347-2800 or (03) 318-8338 or email email@example.com
Late applications will be held over until the next meeting.
Retrospective applications are not considered.
Check before submitting: Are your files attached? If you received any submission errors, you will need to re-attach your files.