Community Service

Application for Community Service Grant from
Rotary Club of South Wairarapa Martinborough Fair Charitable Trust Inc.

Please review the Community Services Grant Funding Criteria document

Name of person or group applying for funding*

Postal address*

Contact Person*

Phone Number*

Email Address*

Is the applicant GST registered?* Yes No

Bank Account Number*

Charities Commission Registration Number

Main activity of the organisation*

What you hope to achieve and who will benefit.*

Total Project cost (inc GST)*

If the project has more than one stage, detail the costs of each stage.
(Multi-stage projects will require photographic evidence of progress before staged funding is released)

Name of person in charge of the project*

What other funding is being contributed to this project?

Funds from your organisation*

Funds from other organisations (detail names and amounts received or pledged)*

Project timing (when is funding required)*

How much is this application for?*

Protocols in place to ensure that the funds are correctly spent and accounted for*

OTHER DOCUMENTATION REQUIRED:

1. The names and addresses of the current committee or governing body of your organisation.

2. A copy of the latest set of accounts prepared by your Treasurer and presented to members of the organisation.

3. Covering letter and any other documentation which you feel may assist the Rotary Club in reaching its decision.

Tip: You can upload multiple documents here, by using the ctl-click or Option-click selection method or you could combine all your documents together into one compressed file (zip, tar, gz, 7z ) and upload that.

You can download 7-zip here

Supporting Document upload*

In making this application all information provided is true and accurate.
The funds received will only be used for the purposes stated in this application.
The support of the Rotary Club of South Wairarapa Martinborough Fair Charitable Trust Inc. will be acknowledged.
A written report on the progress and/or completion of the project will be provided to the Rotary Club of South Wairarapa.

Community funding criteria document

Agreed*

Name and position*

I have read and understand the Funding Criteria (above)*