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Application worksheet

A printable version of Waitaki District Council - Donald and Nellye Malcolm Trust Grant'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

Donald & Nellye Malcolm Trust Grant Application

Waitaki District Council - Donald and Nellye Malcolm Trust Grant

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.waitaki.govt.nz/About-Waitaki/Living-here/Supporting-our-community/Community-Grants-and-Awards/Donald-Nellye-Malcolm-Trust.

1. Applicant Details

Is the Postal Address Different?*

(Select one option)

Yes
No

Contact Person*

Address*

Phone Number*

Email*

Name of Applicant/Organisation*

Street Address*

Postal Address

Applicant Name*

Position*

Principal Officials*

Chairperson*

Secretary*

Treasurer*

2. Aims, Objectives and Purpose

Briefly state your Organisations Aims and Objectives*

Number of Members in the Organisation*

Number of people expected to benefit from the grant*

State the purpose of your application*

3. Grant Information

Grant Amount*

How much are you applying for

Your organisation’s contribution to the project*

Balance of Cost*

Total Cost of Project*

Funds required by*

4. Funding History

Include a copy of your organisation’s most recent annual accounts and balance sheet and explain any unusal items*

Attached

If your organisation has received any grants from this trust in the last five years please detail*

Do you anticipate any siginificant change in your organisations financial position in the next twelve months*

5. Applicants Declaration

Applicants Declaration*

This application has been lodged with the approval of our controlling committee and the information supplied is true and correct. I understand that the information provided in this application will be treated in confidence and available only to the Trustees and Trust Secretary for the purposes of deciding grant allocations and further understand that no discussion or correspondence shall be entered into between the applicant and the Trust. I understand also that a list of successful applicants and the sums granted to them will be made available to the public.

Name*

Position*

Date*

Signature*

Documents to attach

  • a copy of your organisation’s most recent annual accounts and balance sheet and explain any unusal items
  • if your organisation has received any grants from this trust in the last five years please detail

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