Last reviewed: Wed, 18 Aug 2010

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Creative New Zealand Christchurch Creative Funding Schemes

Fields marked * are required

Please be aware of the following:

This entire form must be completed in one sitting as you cannot save.
You should review this form and prepare all the answers before you begin.
For your own records, please print this form when completed, before you press submit.

Within a few days of submitting this form, you will receive access to a 'self-service portal' which will allow you to upload any supporting documents that may be required. If you do not have electronic versions of these, hard copies can still be sent in once requested.

Section 1: Applicant details

1. Name of Applicant (group, organisation or individual) *

2. Address

Postal address *

Physical address (if different)

3. Contact details

Phone number (day time) *
Email *
Website

4. Main contact person for this project

First name *
Last name *
Phone number (daytime) *
Email
Preferred contact method

5. What is the ethnic group that you or your group most identify with? ( for example, New Zealand European, Maori or Samoan)

Section 2: Project details

6. Which of the scheme's three funding criteria are you applying under? *

7. Is your project targeted at a particular section of your community? (Hold the control key to select more than one) *

8. Which of the following arts activities best describes your project?

9. Project name *

10. Description of your project *

What is it you want to do?

11. How will your project benefit your community? *

12. How will you carry out your project, and where and when? *

13. The people

Who is involved? (include brief information about key individuals or organisations)

Section 3: Budget

14. GST number

Applicants that are not GST-registered need to provide budget figures that include GST
Applicants who are GST-registered need to provide budget figures that exclude GST. Successful applicants who are GST-registered must submit a separate GST invoice. Contact your local scheme administrator for more information
Where appropriate, please include copies of written quotes

15. Project costs eg, materials, venue hire, promotion, equipment hire, personnel costs

Item	Total cost ($)
Fees
Material
Promotional and marketing
Sound
Lighting
Venue hire
Other

16. Project Income eg, ticket sales, sale of artwork, etc

Item	Amount ($)
Funds on hand
Sales of work, art, programmes etc
Sponsorship
Box office income
Charge to participants
Other - give details

17. Total funding sought (expenditure - income)

18. Tell us about any other funding you have applied for or received for this project

19. Tell us about any other grants you have previously received through the Creative Communities Scheme

20. Bank account number

- - -

Example: 01-0123-0012345-000 (If you have a two digit suffix please put a 0 before the number i.e 01-1234-0012345-25 would be entered as 01-1234-0012345-025)

Section 4: Declaration

Once the form has been submitted you will be able to attach an electronic copy of a bank deposit slip through the 'self service portal'

I delcare that the information supplied is correct. If the application is successful, I/we agree to:

complete the project within a year of the funding being approved
complete and return a project report form (which will be sent with the grant) within two months after the project is completed
participate in any funding audiot of my organisation or project conducted by the local council if required
inform the scheme administrator of any public event or presentation that is funded by the scheme
acknowledge the assistance of the scheme verbally at event openings, presentations, performances and such like
use the CCS logo in publicity for the project and follow the guidelines for use of the logo. (Logo and guidelines can be downloaded from creativenz.govt.nz/en/about-creative-nz/logos)

For the purpose of processing this application and assessing our group's eligibility, we authorise the Council to:

Collect information about this application and our group from, and disclose such information to, third parties;
and
Collect, retain, use and disclose personal information about individuals who are noted in this application. We confirm we have consent to authorise this.

We solemnly declare that the details contained in this application are true and correct to the best of our knowledge and we have authority to commit to the above conditions.

Authorising Unit: Information Management and Communications Technology

Last reviewed: Wednesday, August 18, 2010

Next review: Thursday, August 18, 2011

Keywords: creative communities

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