Application for Assistance
Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email enquiries@waitomo.govt.nz, Website www.waitomo.govt.nz
1. About your Organisation
Full Name
Postal Address
Contact Numbers
Contact Person
2. About your Project
Give a brief description of the project for which you are seeking nancial assistance
Commencement Date of Project
Completion Date (if applicable)
Project Cost
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How much money have you raised?
a) Amount already spent on the project
b) Amount in hand for the project
Total (a+b)
The total is made up as follows:
Bank Overdraft
If you obtained donated materials towards your project, please state what they are and
their approximate value at market price
Give a brief description of how much voluntary eort (skilled or unskilled labour) has been put into
your project
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What will happen to the assets of the organisation in the event of it being wound up?
How much nancial assistance do you wish to apply for from the Trust?
Number of people who will benet from the project?
3. Funding from other Parties
If you have received any other Government, National Lottery or Local Authority funds in the last 3
years, or if you have another application currently being considered by Government or the Lottery
Authorities, please give details
To whom applied
4. Further Information
Please add any further information about your project or about your organisation which you think would
help in the consideration of your application
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5. Declaration and Consent
In making this funding application I/we declare that:
1. I am authorised to do so and to the best of my knowledge the information contained herein is true
and correct.
2. Any funding received will be used for the project for which is was approved.
3. If the application is successful, on completion of our project, I agree to provide an accountability
report to the Waitomo District Council.
4. I consent to the Waitomo District Council collecting, retaining and using the contact details of our
organisation that have been listed in this application.
5. I agree to repay Waitomo District Council all funding that is not used for the purposes outlined in
this application.
6. I will make provision for the continued community use of any facility assisted by the DC Tynan Trust
in the event of our organisation winding up.
6. Checklist
Please read the attached Guidelines for Funding and complete the following before submitting your ap-
plication. If you would like help to complete this application, please contact a member of the Customer
Services Team. Incomplete or late applications will not be accepted.
Applicant Use
Completed ALL sections of the application?
Checked all gures within the application?
Attached a copy of your organisation’s latest annual accounts?
A detailed quote for the item/s for which you have applied funding for?
Attached a Bank Deposit Slip (If a donation is approved, payment will be direct
credited into your nominated account)
Please send completed applications to:
Waitomo District Council
PO Box 404
Te Kuiti 3941
Ph: 07 878 0800
Fax: 07 878 7771
Have you:
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Schedule of grants allocated in the last 3 years
Organisation Amount
Funds Allocated For
King Country Junior Hockey $1,624.00 Hockey goalkeeping equipment
Te Kuiti Netball/Tennis Pavillion
Society Incorporated
$6,114.55 To paint the exterior of the Netball/Tennis
2016 Total $7,738.55
Kitty Korner Charitable Trust $250.05 Animal crates for foster homes
Friends of Hillview Trust
$1,800.00 Purchase of pressure point mattresses
Te Kuiti Playcentre $1,500.00 Playhouse for dramatic play area
Te Kuiti Croquet Club $500.00 Dawson international croquet balls
Brook Park Incorporated Society $3,500.00 Metal for new mountain bike track
2017 Total $7,550.05
The Rotary Club $4,000.00 Purchase of items for clubrooms
Centennial Park Primary School $2,881.65 Core values signage for display around school
2018 Total $6,881.65
DC Tynan Trust - Guidelines for Funding
The following guidelines are prepared to assist applicants in the preparation of their application. Please
read carefully.
Funding will be available for organisations within the Te Kuiti dened urban area only.
The Trustees have absolute discretion to decide the allocation of funding within the terms of the
bequest, which encompasses social, cultural, educational and recreational activities.
Funds will not be available where a project either has commenced or has been completed prior to
the advertised closing date.
The Trustees generally receive many more applications than there are funds available and each
application will be considered on its merits.
Funds will not be allocated to those applicant organisations which have received funding from the
Trust in the previous three years.
Generally, funds will not be available for maintenance type activities or minor projects, which could
be more appropriately met from the general funds of the organisation.
Applicants will be encouraged to submit applications for capital-type items, which give benet to a
greater number of participants.
The Trustees believe applicants should demonstrate their commitment to the project by providing
evidence of provision of a substantial contribution towards the project. This contribution can be by
way of monies, labour or assistance “in kind”.
Funding will generally be available to those applicant organisations where the project can be
completed within the nancial year of the allocation.
If the funds are not uplifted within the nancial period of the allocations then the amount allocated
may be re-allocated, or re-invested to the capital fund.
Applicant organisations which have been allocated funding will be required to provide evidence that
any stipulated criteria has been met prior to the funds being made available.
All successful applicant organisations will be required to complete a receipt form acknowledging the
amount allocated has been received.
All successful applicant organisations will be required to complete an Accountability Form providing
details of exactly how the amount allocated has been spent.
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