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Project Submission Form
Project Submission Form
Xanthe Rivett
2019-01-18T15:14:14+10:00
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Applicant Details
Applicant Name
*
For publication on website
Contact Phone
*
Contact Email
*
Contact Address
*
Would you like to make a simple or detailed budget submission?
Hint: if you are a making a bid for project funds, a detailed bid is useful. If you are a community member making a suggestion for roads, footpaths, playground improvements (for example) a simpler submission is a good option
.
Simple Submission
Detailed Submission
Preferred method of contact
*
Email
Post
Phone
Budget Amount (if known)
For publication on website
Are you making the submission as an individual or club / group / organisation
*
Individual
Club / group / organisation
Name of Group, Club or Organisation
Does your group, club or organisation have an ABN?
Yes
No
Does your group, club or organisation have insurance?
Yes
No
Project Details
Short description of your project
i.e. Upgrade of roundabout on Main St, Mornington or New playground at Olympic Reserve, Rosebud.
Site Location (if applicable)
How will this project make a difference to the community?
What are the proposed project goals and benefits?
Do you currently have money (partial or otherwise) to fund this project?
If yes, please detail.
Do you plan to seek additional funding sources, i.e. grants, donations, etc.
If yes, please detail.
Are there other community members, organisations, businesses, etc. that you are, or might, work with to help deliver this project?
Are there key stages, timelines of dates for this project?
Is the project likely to span over multiple financial years? If yes, please provide a basic breakdown of different stages / funds need in different years.
Has funding previously been sought for this project?
Yes
No
Will this project require ongoing maintenance or continued financial support from the Shire? (if known)
Yes
No
Do you want to be heard at the Forward Planning Meeting?
*
Yes
No
Additional submission details
(if known, for publication on the website)
Submission attachment/s
For publication on the website
Please upload any additional details / files you would like to include with your submissions. Such as a basic site plan / map of the project, concept drawings, photos, etc.
Drop files here or
Select files
Accepted file types: pdf, doc, jpg, png, xls, Max. file size: 15 MB, Max. files: 5.
All or any part of this submission will be made public and I have read the confidentiality statements
*
I understand
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Project Category
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Supported
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UDFnames
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UDFvalues
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UDFs
Email
This field is for validation purposes and should be left unchanged.
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