This Report is due as soon as the funds are spent, or within one calendar year of receipt of the grant, whether allocated funds were spent or not.

This form must be completed in one session.

If you encounter any issues with the application form, please contact  funding@selwyn.govt.nz.

Privacy Notice

Personal information collected through this form will be used to assess your grant application and will be handled in accordance with the Privacy Act 2020 and Selwyn District Council’s Privacy Policy [PDF, 6494 KB].

Group Information:
Funding Details:
Month/Year subsidy was received from the Rural Travel Fund: *
Did you use the fund for the purpose specified in your application? *
Benefits of Receiving Funding:
Please briefly explain.
Declaration:
Personal information collected through this application will be handled in accordance with the Privacy Act 2020 and Selwyn District Council’s Privacy Policy.
I declare that the above information is correct. * • I declare that I have been authorised by my organisation to complete this accountability report and that the information supplied is correct.

• I agree to keep receipts relating to this project for a minimum of one year as a random selection of grants are audited by Selwyn District Council each year where evidence of expenditure will be requested.

Privacy statement

The personal information you provide in this form will be collected, held and protected by Selwyn District Council in accordance with our Privacy Policy and the Privacy Act 2020. Our Privacy Policy explains how we use and share personal information in relation to any interaction you have with Council, and how you can access or correct your information at any time.

You can read the full policy at selwyn.govt.nz/privacy.

We will use the email address you provide to send communications directly related to this form or application. By submitting this form, you consent to receive those communications by email. If you require a hard copy, please email ContactUs@selwyn.govt.nz, visit our Service Desk Team or call 0800 SELWYN (735 996).