Queen Street, P O Box 404, Te Kuiti 3941, NZ. Telephone 07-878 0800, Fax 07-878 7771, Email info@waitomo.govt.nz, Website www.waitomo.govt.nz
Community Development Fund Policy
Discretionary Grant Application
Waitomo District Council provides a Discretionary Grants budget each nancial year to
assist community clubs, groups and organisations. Applications are considered and
determined on a quarterly basis.
The focus of the Discretionary Grant Fund (DGF) is in providing community assistance for
the ‘not for prot’ sector in order to create a strong social base and meet local needs.
Grant Eligibility
To be eligible for funding assistance applicants need to demonstrate that the activity
to be funded will benet a group or groups of residents and ratepayers of the Waitomo
District.
The DGF does not support funding applications submitted by individuals. Organisations
and groups must operate within Waitomo District, be able to present annually reviewed
or audited nancial statements and reports, and must be:
An Incorporated Society
A Registered Charitable Trust
Controlled or co-ordinated by an arm of Central or Local Government
Controlled by an association of persons under an adopted constitution rules
A Limited Liability Company fully owned by one of the above and operating for
charitable purposes
Applications should include a prole summary of your group/organisation including
purpose, activities, services, goals and objectives.
Groups Subject to Additional Conditions
Education Based Groups
The DGF will not fund education based activities which should, in the view of a
reasonable person, be the responsibility of their primary funder i.e Ministry of Education.
The fund only supports projects sponsored by education providers where there is a clear
general community benet that will be derived from such a project.
For-Prot Groups
The DGF does not fund For-Prot Groups.
A413983 : P1 of 9
Supported Projects
Examples of projects supported may include:
Administration and operational costs e.g stationery
Training costs for personnel
Initial project costs e.g advertising
Public education events
Hall/facility hire
Equipment hire
Ineligible Projects
The following are examples of projects that would be deemed ineligible for support via
the Discretionary Grants Fund:
Items of a capital nature e.g buildings, furniture
Travel
Food and refreshments
Loan/debt repayment
Wages or subscriptions
Individuals
Completed projects
Incomplete or Ineligible Applications
All incomplete or ineligible applications will not be considered for funding during the
funding round.
Community Development Fund Policy
Organisations considering applying for funding should read the Community
Development Fund Policy to ensure that they understand and meet the eligibility
criteria prior to lodging an application.
A413983 : P2 of 9
Community Development Fund
Discretionary Grant Application
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
Phone
Mobile
Fax
Contact Numbers
Physical Location
Email
Years of Operation
Purpose - What are the organisations main purpose and objectives?
Organisational Categories
Please identify which of the following areas your organisation supports. Tick as many, or as few, as appropriate.
Culture and Recreation
Health
Education and Research
Social Services and Emergency
Relief
Environmental and Animal
Protection
Development and Housing
Civic and Advocacy Groups
Philanthropic Organisation,
Aid and Relief
International Organisations,
Aid and Relief
Religious Congregations
and Associations
Business and
Professional Associations
Not elsewhere classied
Legal Status
Trust
Incorporated Society
Formally Constituted Society
Informal Group or Committee
Other (Please Describe)
A413983 : P3 of 9
2. About your Project or Initiative
Describe your Project - Please describe the project you are seeking further support for.
Length of Project/Anticipated Completion Date - How long will your project or initiative continue
for?
Community Benet - How will the Community benet from your project or initiative?
Project Focus
Is your project or initiative focused within the Waitomo District?
Yes
No
Name
Position
Phone(day)
Email
Referee Details
Name
Position
Phone(day)
Email
Contact Persons
Two contact names are required. These must be the same people who make the declaration on behalf of your organisation
on page 7 of the application.
Name
Position
Phone(day)
Email
Name
Position
Phone(day)
Email
If yes, which of the following Community Categories will benet from the project or initiative?
Tick as many, or as few, as appropriate.
Urban
Rural
All of District
A413983 : P4 of 9
3. Community Outcomes
The basis of this Community Development Fund is to ensure recipients are undertaking projects that
make a positive contribution to achieving the Council’s Strategic Community Outcomes. Below is a list
of Community Outcomes that contribute to the Community Development Activity. Please identify which
outcomes your project or activity will contribute to. Tick as many or as few as appropriate.
4. Funding for this Project or Initiative
If you are GST registered, please do not include GST in these costs.
Please round all gures to the nearest dollar.
Please list separate costs (attach written estimates for verication) and not just a total gure.
Expenditure
Cost of the Project
A Total Cost of
Project/Service
$
Total Amount Applied
for(A - B)
$
Vibrant Communities
A place where the multicultural values of all its people and, in particular, Maori heritage and culture is
recognised and valued.
A place where all age groups have the opportunity to enjoy social, cultural and sporting activities within
our District.
A place where young people have access to education, training, and work opportunities.
A place where young people feel valued and have opportunities for input into the decisions for the District.
A place where we preserve the natural environment for future generations, ensuring that natural resources
are used in a sustainable manner.
Thriving Business
A place that attracts more people who want to live, work and play, and raise a family.
A place where wealth and employment are created through local businesses and tourism opportunities and
facilities are developed, facilitated and encouraged.
Eective Leadership
A place where the development and partnerships for the delivery of programmes and services is encouraged
and pursued.
Income
How do you plan to fund the project
B Funds for
Project/Service
$
A413983 : P5 of 9
5. Funding from other Parties for this Project or Initiative
Have you applied to, or do you intend to apply to, or will you receive funding from any other group for
this project or initiative?
No
Yes
If Yes, please detail below:
Name of Group $
6. Previous Council funding for this Project or any other Service
Have you received nancial assistance from Waitomo District Council during the last three years for any
purpose? (i.e. rates relief, reduced rental, previous annual grants / discretionary grants)
No
Yes
If Yes, please detail below:
What was the purpose of funding?
$
A413983 : P6 of 9
7. Previous Funding for any other Projects or Initiative
Have you received nancial assistance from any other body or organisation during the last three years
for any purpose?
If Yes, please detail below:
What was the purpose of funding? $
No
Yes
8. Financial Accounts
Please supply a copy of your organisations last Annual Financial Report, or, in the absence of the
Financial Report, a statement of income and expenditure for the past 12 months. If neither of these
documents is available, please explain why below and attach a copy of your organisations latest bank
statement/s.
A413983 : P7 of 9
9. Volunteer Support
What level of volunteer support will this project or service receive from your organisation?
Number of volunteer workers involved?
Describe the work volunteers will undertake
Resources supplied by volunteers
Please add any further information you may wish to provide. This could include details of how you
think the project will benet our community or what the impact would be on the community if the
project is not provided. Letters of support from other members or organisations within the community
would assist with dening the level of community benet.
10. Further Information
A413983 : P8 of 9
11. Declaration and Consent
In making this funding application I/we declare that:
1. I/we are authorised to do so and to the best of my/our knowledge the information contained herein
is true and correct.
2. Any funding received will be used for the project/initiative for which is was approved.
3. If the application is successful, on completion of our project/initiative, I/we agree to provide an
accountability report to the Waitomo District Council.
4. I/we also 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/we agree to repay Waitomo District Council all funding that is not used for the purposes outlined
in this application.
6. I/we have read the appropriate fund policy.
Name
Signature
Position
Date
Name
Signature
Position
Date
Please read and complete the following before submitting your application. Incomplete or late
applications will not be accepted.
Completed ALL sections of the application?
Checked all gures within the application?
Attached a copy of your Financial Report/Accounts?
Attached Referee Details - Letters of Support?
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:
12. Checklist
Applicant Use
Oce
Use
Evidence of Legal Status (e.g. Certicate of Incorporation, AGM Minutes)
A413983 : P9 of 9
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome