[Type here]
Your declaration:
I/we hereby declare the information supplied in this application is correct. If the application is successful, I/we agree to
provide an accountability report to the EDGB stating that the money received has been spent on the project or service as
requested. I/we agree to participate in any funding audit of our organisation conducted by EDGB.
I/we also consent to the EDGB collecting, retaining and using the contact details of our organisation that have been listed
in this application. I/we confirm we have the authority to provide these details and to commit the organisation to this
application. Where funds are approved, I/we agree to acknowledge the EDGB in all promotions carried out.
PLEASE NOTE: Complete one application form per project. Please use black pen to complete your details. The Socio Economic
Development Officer is available if you require assistance, phone 027 351 7081 or email rachel.fifield@bds.govt.nz
Please ensure you attach all the required supporting information. Failure to include all relevant information may delay the processing
of your application.
Checklist for supporting information, the following information is required in support of your application:
Please ensure that you have completed ALL sections of the application. If information is not provided, it may
delay your application.
Two letters of community support for your organisation, signed, dated and less than six months old,
from people not involved or connected in any way with the running of your organisation.
Full details of your project(s) with site plans, work timelines, and any other project related information
that will identify your project and vision
A copy of your organisation’s latest annual reviewed accounts. If you do not have annual accounts,
please attach a statement of income and expenditure for the past 12 months. If neither of these
documents are available please explain why below, and attach a copy of your organisation’s latest bank
account statement/s.
Checklist
Before submitting your application please complete this check list:
My project takes place in Reefton.
I have answered all the questions in the application form.
I have provided estimates/quotes of project costs.
I have provided an expected timeline which includes key milestone dates for the delivery of the
project.
I have provided relevant supporting documentation including two letters of support.
I have read and signed the declaration.
Send your completed application to: Socio-economic Development Officer, PO Box 100, Reefton or
email to rachel.fifield@bdc.govt.nz
