Application worksheet
A printable version of Waitaki District Council - Sport NZ Rural Travel 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 →Application worksheet
Sport NZ Rural Travel Fund Application Form
Waitaki District Council - Sport NZ Rural Travel 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.waitaki.govt.nz/About-Waitaki/Living-here/Supporting-our-community/Community-Grants-and-Awards/Sport-NZ-Rural-Travel-fund.
1. Contact Names
Contact Person*
Phone Number*
Email Address*
PO Box Address
Name of Organisation*
First Contact Phone*
Second Contact Phone
Postal Address
First Contact Name*
How many members belong to your Club/School?*
How many participants aged between 5 & 18 will this travel subsidy benefit?*
How many participants are aged between 5 & 11 years?*
How many participants are aged between 12 & 18 years?*
How many participants are female?*
How many participants are male?*
Second Contact Name
Are you a Club or a School?*
2. Organisation Details Continued
What is the funding going to be used for?*
Does your application involve a partnership with a local School or Club?*
Are you registered for GST?*
Do you have any individuals who are disabled that would be supported by this fund?*
If yes, how many will receive support from the Rural Travel Fund?
What percentage of your members live in the vicinity of the local authority you are applying to for the Rural Travel Fund?*
If yes, please write your GST Number below
How much money are you applying for?*
Sport NZ Funding*
Other Funders
Your Contribution*
TOTAL*
If you have applied for funding from other organisations please supply details
Organisations (including other councils)
Results Date (if known)
3. Financial Details Continued
Applicants Declaration*
Name*
Position*
Signature*
Name*
Position*
Signature*
Have you answered every question?*
Have you attached the relevant documents with your application?*
Do you have endorsement from your local affiliated Club/School for this application for funding?*
If yes, briefly explain and attach evidence of this
Documents to attach
- Latest financial statements from your organisation (i.e. P&L, financial statement)
- A deposit slip (in case your application is approved)
- Evidence of your endorsement from your local affiliated club/school (if required)
Declarations
- We hereby declare that the information supplied in this application is correct.
- We consent to Waitaki District Council collecting the personal contact details and information provided in this application, retaining and using these details and disclosing them to Sport NZ for the purpose of review of the rural travel fund. This consent is given in accordance with the Privacy Act 1993.
Signature
Date
Worksheet generated by All Too Human (alltoohuman.nz/grants). Source: official PDF. This is not an official submission form.