Claremont Community Funding Application Form

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Applicant Details

Name *

Email *

Is your group/organisation not-for-profit? *

Yes

Group or Organisation *

Phone number *

Project Details

Grant Amount Requested *

Total cost of Project (up to $5K) *

Quotes for items or services above $500.00

Project Start Date *

Project End Date *

Services and activities of the proposed project, and how it will benefit the town *

Why would this project not proceed without funding? *

Project objective *

Project outcomes *

Describe any ongoing benefits to your group and the Town of Claremont *

Are the services/activities of the project directed primarily towards residents of the Town of Claremont? *

Yes

Does the proposed project duplicate other existing services within the Town of Claremont? *

Yes

Authorisation

Signature *

Position *

Date *

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