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Application worksheet

A printable version of Palmerston North City Council - Green Shoots Fund'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 →

Assessment Form SPG 25-28

Palmerston North City Council - Green Shoots Fund

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.pncc.govt.nz/Community/Community-funding/Green-Shoots-Fund-–-helping-you-build-a-greener-future.

1. Assessor declaration

Conflict of Interest **

○ I do not have a conflict of interest

○ I do have a conflict of interest

Confidentiality **

As an assessor for Palmerston North City Council, you are being given access to confidential and, in some cases, private and sensitive information. You must agree to the statement below in order to proceed with this assessment:

○ I agree

○ I do not agree

2. Application assessment

Viability score*

Indicators: • The applicant has the capability, capacity and experience to deliver the work • The applicant has a relevant track record of successful delivery • The applicant has the necessary experience, networks or profile to give them credible access to the people who will benefit • The applicant has a sound history (if any) of compliance with Council obligations • The application budget is realistic and evidenced-based • Funding would help the applicant to become stronger or more sustainable in the future • The applicant is in a strong financial position

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Comments on 'Viability'

Your comments can be in bullet points. Please provide short and concise rationale for your recommendation.

Outcomes score*

Indicators: • The applicant understands the difference they are trying to make in the community • The applicant has clearly defined the expected outcomes of their work • The expected outcomes are important to the Palmerston North community • The project, activity or service described is likely to achieve the expected outcomes • The applicant has given thought to how they will show the grant will benefit the community • The applicant has demonstrated how they will evaluate the success of the work

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Comments on 'Outcomes'

Your comments can be in bullet points. Please provide short and concise rationale for your recommendation.

Alignment score*

Indicators: • The expected outcomes clearly align with the Council's goals and contribute to achieving Council's outcomes for the community • This applicant provides evidence of collaboration with other organisations.

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In your opinion, which outcome(s) does this application most contribute to?

Goal 2: A creative and exciting city Outcome 1: a vibrant city that connects people, and where creativity is built into our cityscape Outcome 2: an arts community and cultural facilities that are well supported and invested in Outcome 3: our unique heritage preserved and promoted Outcome 4: opportunities to celebrate our many cultures Outcome 5: access to exciting, well-managed events and activities throughout the city and its neighborhoods Outcome 6: places across the city and its neighborhoods for communities to take part in play and recreation Goal 3: A connected and safe Community Outcome 1: access to services and facilities that are inclusive and appropriate for their needs Outcome 2: the support they want to live healthy lives Outcome 3: access to healthy and affordable housing Outcome 4: opportunities to contribute to the design of our city Outcome 5: access to safe and accessible community places Outcome 6: community social service groups and facilities that are well supported and invested in Goal 4: A sustainable and resilient city Outcome 1: access to relevant information and education to support more sustainable choices Outcome 2: a sustainable and low-emissions city Outcome 3: a circular economy with more resource recovery and less waste Outcome 4: a healthy, thriving, ecosystem, including native biodiversity and food security Outcome 5: the Manawatū River and waterways restored to a healthy, respected, and connected state Outcome 6: sustainable urban planning with a low carbon-built environment Outcome 7: natural environment-focused community groups and facilities that are well supported and invested in

Comments on 'Alignment with funding outcomes'

Your comments can be in bullet points. Please provide short and concise rationale for your recommendation.

Total score

This number/amount is calculated.

Recommendation*

○ Yes, fully

○ Yes, partial

○ No

Final Comments

Your comments can be in bullet points. Please provide short and concise rationale for your recommendation.

How long did you take to complete this assessment?

Worksheet generated by All Too Human (alltoohuman.nz/grants). Source: official PDF. This is not an official submission form.