/ Grant Application

Grant Application

Your Organisation's Details
This should be the same as the bank account name.
Street address and PO Box number
Contacts
Please supply two contacts from your organisation with a brief description of their roles and their mobile numbers.
Grant Amount
About The Grant
Please be specific about the detailed use of the grant.
Wage Funding
e.g. Joe Blogs, Coach
$
e.g. $50,000
$
e.g. $10,000
About Your Organisation
(refer www.nzbn.govt.nz)
Budgets
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx xls xlsx.
(if currently being audited, please provide a draft copy). NB: Financial information on reserves/cash on hand/investments must be included
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx xls xlsx.
Details on other funding received
Bank Details
Declaration
  • We declare that the information provided in this grant application is true and correct, to the best of our knowledge, and we have the authority to make the application on behalf of the applicant.
  • This organisation fully understands that any and all grant monies received from the ILT can only be used for the purpose for which the grant was approved. Copies of invoices, receipts and bank statements (where applicable), along with any unspent funds, will be returned to the ILT after the funds have been applied towards the purpose for which the grant was made.
  • We authorise the ILT to retain information pertaining to this application and to disclose that information as deemed necessary by the ILT for any purpose, including the publication of grants.
  • We have read, understand and accept all the conditions applicable to this application for a grant. The funds will only be used for the purpose applied for in this application.

Please use your mouse to sign in the signature box above.

Please use your mouse to sign in the signature box above.