PART 3: DECLARATION
Creative Communities Scheme Application Form 6
You must read and sign the following. Please place an X in each box to show that you have read the information and
agree to each section.
I/We understand that if this application is successful I/we cannot receive funds for the same project from Creative
New Zealand’s other funding programmes.
I/We declare that the details contained in this application are correct and that I/we have authority to commit to the
following conditions.
If this application is successful, I/we agree to:
complete the project as outlined in this application (or request permission in writing from the CCS Administrator
for any significant change to the project)
complete the project within a year of the funding being approved
complete and return a project report form (this will be sent with the grant approval letter) within two months after
the project is completed
return any unspent funds
keep receipts and a record of all expenditure for seven years
participate in any funding audit of my organisation or project conducted by the local council
contact the CCS administrator to let them know of any public event or presentation that is funded by the scheme
acknowledge CCS funding at event openings, presentations or performances
use the CCS logo in all publicity (eg poster, flyers, e-newsletters) for the project and follow the guidelines for use
of the logo. Logo and guidelines can be downloaded from the Creative New Zealand website:
http://www.creativenz.govt.nz/about-creative-new-zealand/logos
I understand that the Waitomo District Council is bound by the Local Government Official Information and
Meetings Act 1987
I/we consent to the Waitomo District Council recording the personal contact details provided in this application,
retaining and using these details, and disclosing them to Creative New Zealand for the purpose of evaluating the
Creative Communities Scheme.
I/we understand that my/our name and brief details about the project may be released to the media or appear in
publicity material.
I/we undertake that I/we have obtained the consent of all people involved to provide these details. I/we
understand that I/we have the right to have access to this information.
This consent is given in accordance with the Privacy Act 1993
Name
(Print name of contact person/applicant) (Print name of parent/guardian for applicants
under 16 years of age)
Signed: Signed:
(Applicant or arts organisation’s contact
person)
(Parent/guardians signature for applicants
under 16 years of age)
Date: Date:
click to sign
signature
click to edit
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