Application worksheet
A printable version of Manukau Community Facilities Charitable Trust's application questions, extracted from their official form. Use it to plan your answers - then submit through the funder's real form.
View the original PDF →Application worksheet
Manukau Counties Community Facilities Charitable Trust - Application for Funds Form 2023
Manukau Community Facilities Charitable Trust
This worksheet mirrors the questions on the funder's official application form. It is NOT the official form. Submit your final answers through https://www.maxserv.co.nz/mccfct.
1. Recipient Organisation Information
Name of Recipient Organisation (Applicant):*
Type of Organisation:*
(e.g. Charitable Trust, Non-Profit, Sports Club, Community Organisation, School, National Sports Body etc.)
Address: Mail:*
Address: Physical:*
Post Code:*
NZ Business #:
Application Contact:*
Contact Mobile #:*
Application Contact position in Organisation:*
eg: Secretary
Is the Application Contact a Professional Fundraiser?*
Email:*
Is the organisation registered with the Charities Commission?*
Is your organisation affiliated to a Regional / National Organisation?*
Is your organisation an Incorporated Society?*
2. Grant Purpose
What is the Grant to be used for? (Please be specific):*
3. Costs
Costs: (use separate sheet if necessary. Provide precise details of how or what the grant money will be spent on supported evidence supporting the total amount sought (e.g. by 2 competitive quotes/other evidence of costs))*
Total Amount $*
Amount requested: $*
Has the applicant organisation applied for funds for the same purpose from any other source?*
Is your organisation registered for Good and Services Tax (GST)?*
4. Declaration of True & Correct Information and Consent to Audit
DECLARATION OF TRUE & CORRECT INFORMATION AND CONSENT TO AUDIT*
Name:*
Signature:*
Position:*
Please advise any Conflicts of Interest:
Documents to attach
- A pre-printed deposit slip or bank certification in the name of your organisation.
- A copy of the resolution/minutes of the committee to apply for funding and that the Secretary has signed as a true and correct copy.
- A copy of the Certificate of Incorporation (if the organisation is incorporated), or confirmation of charitable status.
- Confirmation that your team/club/organisation is affiliated to a recognised regional or national body.
- A copy of your organisations latest signed Annual Financial Accounts.
- A copy of 2 current competitive quotes for each item (or valid reason in writing where only one quote can be supplied). Quotes must be on supplier letterhead.
Declarations
- We understand that the funds can only be used for the purposes stated and that any funds not used in this manner will be returned to MCCFCT. We agree to provide any information required regarding the grant to MCCFCT on request including the provision of receipts or other proof of how the funds were used.
- We agree to comply with a request from an Officer of the Department of Internal Affairs for additional information in relation to how the monies received by this Organisation/Society from the operation of gaming machines have been spent.
- We agree than an Officer of the Department of Internal Affairs may direct an audit or inspection of the books, accounts, or data systems in which the proceeds of the operation of the gaming machines received by this Organisation/Society have been deposited. This may be conducted by: (i) a Charted Accountant in public practice, or (ii) a person appointed by the Department of Internal Affairs.
- We agree that the audit or inspection will be carried out in a manner approved by the Department, within the timeframe specified by the Department. This Organisation/Society shall pay for the cost of such an audit.
- We hereby consent to the above audit conditions and certify that the information in the application together with any supporting details, is true and correct. We also certify that we have the authority to make this application on behalf of the organisation.
Signature
Date
Worksheet generated by All Too Human (alltoohuman.nz/grants). Source: official PDF. This is not an official submission form.