NCPAF Big Idea Fund expression of interest form

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NCPAF Big Idea Fund expression of interest form

Need help?

If you would like help filling out the application form, contact the Community Liaison Adviser - Recreation on +64 3 546 0427.

Fill out the application in one visit

Once you begin this application, you cannot save a partial application and return to it, please have all the information ready in advance and fill it out at the time you are ready to submit it.

Applicant details

Name of organisation

Postal address

Street address

Email address

Type of organisation

Number of members

Contact person

Contact position

Contact phone

Project Description

What are the purpose and the aims of the project?

Share your planning process for the project, including how you determined the need for the project and any links to best practice elsewhere or research undertaken.

How will the project be sustained in the future?

What impact will the project have on your organisation and the community?

How will you evaluate the achieved outcomes of the project?

What are the key project milestones?

Budget

Estimated total cost of the project

Total request from NCPAF

Referees

Referee Name

Referee Phone Daytime

Referee Phone Evening

Declaration

Please provide two authorised signatures for your organisation. By the submission of this online form, both authorised persons indicate their digital signature to this application.

We hereby declare that the information supplied here on behalf of our organisation is correct and submitted with permission and in the knowledge of our governing body.

We consent to the NELSON CITY COUNCIL collecting the personal contact details provided in this application, retaining and using these details, and disclosing them for the review of the Nelson City Physical Activity Fund.

We undertake that we have obtained the consent of all contact persons to provide these details. This consent is given in accordance with the Privacy Act 1993.

Authorised name # 1

Position in organisation # 1

Date of submission # 1

Authorised name # 2

Position in organisation # 2

Date of submission # 2

Submitting the application

Once you hit the 'submit' button, the entire form is officially submitted and cannot be changed. If you need to make a change to the application, you can resubmit the full application indicating it is a replacement to the first submission.

Please answer this question:

What is the third letter in the word 'peach'?

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