Small Grants Program Application

* = required

I am applying for: * ---Small Grant RoundQuick Response Grant (out of round)
Title of Program or Project: *
Amount Requested: *

Applicant

Name of Applicant: *
Name of Organisation:
ABN:
Email: *
Telephone (inc area code): *
Mailing Address: *

Auspicing Body (if applicable)

Name of Org:
ABN:
Contact Person:
Email:
Telephone:

Project Description:

Please provide a short one or two paragraph description of your project (no more than one page of text) answering the following:

• What is it you want to do?
• Event/Project Timeline:
• Why do you want to do it?
• How the monies will be applied to the project?
• Who will benefit from the project?
• Have you tried sourcing other funds for your project – if so please outline what is the result?
• Briefly describe how does your project further the aims and objectives of the GALFA Small Grants Program?

Project Budget:

Budget Narrative

Please give a description of each item and describe exactly how awarded funds would be used):

Referee:

If available please provide the name and phone contact for a personal or project referee.