ADG Community Grants Program Application Form

ADG Community Grants Program

Application Form 2024 (Initial Application)

Organisation Information

Organisation Contact Person

Name of contact person *

Role *

Phone

Mobile *

Email *

Organisation Details

Name of organisation *

ABN *

Address *

Phone *

Email *

Website

Is your organisation registered for GST? *

YesNo

How long has your organisation been in operation? *

Other (Please Specify) *

Number of members/employees/ attendees? *

Are any members or attendees employed by ADG? *

YesNo

Briefly describe your organisation’s main activities *

Are you applying for grant or sponsorship funding? *

Grant OnlySponsorship

For sponsorship, how will you promote ADG’s support? *

What are the goals of your organisation or event? *

Which geographical locations does your organisation benefit? *

Alice SpringsDarwinTennant Creek

Other (Please Specify) *

Please outline the key outcomes of your organisation, project or event, with reference to the key focus areas above *

How will this project or event be promoted? *

Approximately how many people will be actively involved in the project or event? *

Is there an opportunity for ADG employee involvement? *

YesNo

Please specify the opportunity *

Funding/Donation Requested

Please outline the cost breakdown of your activities

*ADG may request quotes or other documentation to support your cost breakdown.

Item desciption *

Item cost ($) *

Amount requested ($) *

Please detail any contributions from other donors/sources (financial and in-kind) to support your activities

Company/Organisation

Confirmed Support ($ or in-kind details)

Please outline how this contribution will benefit the project *

Please upload supporting documents (if any)

Browse

Timeline

Start Date *

End Date *

Key Milestones (if known)

Milestone

Submission Checklist

I have checked that my organisation is eligible for assistance. *

I have completed the application form and attached any other relevant additional information. *

Applicant Name *

Role in Organisation *

Applicant Signature *

Draw signature|Type signatureClear

Date *

CAPTCHA *

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