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We strongly encourage you to read the 2019 Guidance Notes before completing this application form.

Please complete all questions with relevant information. Refrain from writing more than the word limits, where specified. Do not write ‘see attached’ in place of a response. Please click on grey boxes provided to input your answers. When completed please save and e-mail your response as a word document. Do not save as a PDF. Handwritten applications will not be accepted.

Section 1: Your Organisation1.1 Your organisation’s name

1.2 Physical Address

1.3 Postal Address (if different from above)

1.4 Contact Person (including email and phone number)Name: Position in organisation: Contact number: Email:

1.5 Key people (CEO and Board members) in your organisation

1.6 Are you a registered charity? If so, what is your Charities Commission registration number?

1.7 When was your organisation established?

1.8 How many people will benefit from your work?

1.9 Are you GST registered? If so, please provide GST number

1.10 Tell us about the focus and purpose of your organisation (Maximum 50 words)

2019 SACT Application Form |

1.11 Number of paid and volunteer staff

1.12 In general where does your organisation get funding from?

Section 2: Fit with Priorities2.1 Please type yes for the priorities this funding would impact: Children and young people Low income families Families living in areas of high deprivation Māori and Pasfika

2.2 Please give a description of how/where your organisation impacts these priorities. Provide evidence where possible.

2.3 How many people within each priority group will you impact with this funding? Children and young people Low income families Families living in areas of high deprivation Māori and Pasifika

Section 3: Fit with Outcomes3.1 Please select one outcome that you fit best with:

Enhanced child wellbeingEnhanced youth development and wellbeingFamilies have enhanced financial capability Enhance family wellbeingFamilies have increased opportunities to generate incomeIncreased opportunities for community economic development

3.2 Describe how you will make a positive impact within this outcome area. Include evidence where appropriate and any long-term impact. You can also use this section to discuss how you may impact multiple outcomes.

Section 4: The Project/Programme4.1 Please give a description of the project or purpose for which funding is sought (maximum

150 words)Your answer should include a description of your planned activities.

4.2 What evidence is there that this project/initiative is needed and has a community mandate?Please describe how you know there is a need for your project – this could be through


research data, community consultation or evidence of current demand for services.

4.3 What is the timing of your project - when will it commence and when will it conclude?

Section 5: Evaluating Impact and Organisational Development5.1 What aspect/s of your project or programme do you plan to evaluate? (maximum 100

words)

5.2 Discuss your organisational evaluative approach – how do you measure the effectiveness of your work? (maximum 150 words)

5.3 Describe, if appropriate, how this funding will grow your capacity to achieve better impact or grow your sustainability as an organisation (maximum 150 words)

Section 6: Collaboration6.1 Is your project or programme collaborative?

Yes* – go to section 6.2, No – go to section 6.3* A collaborative project/programme is defined by the SKYCITY Auckland Community

Trust as being co-led by one or more organisations, with a formally recognised partnership (eg Memorandum of Understanding (MOU)), a common vision and shared resourcing – with the intention of achieving greater impact.

6.2 If you answered ‘yes’ to section 5.1, please explain:• The nature of this collaboration • How SKYCITY Auckland Community Trust funding would be managed across the

collaborative partners• How the collaboration enables the project or programme to better achieve its intended

outcomes detailed in Section 3.

6.3 If you answered ‘no’ to question 6.1, please give a brief outline of any active relationship

that your organisation has with others that benefit your project or programme:


Section 7: Cultural responsiveness7.1 How have you considered your target group in the design of this project/initiative?

7.2 How does your governance structure represent your target group?

Section 8: Multi-year funding8.1 Briefly describe the impact multi-year funding would have on the delivery and achievement

of outcomes stated in Section 3

Section 9: Project Funding9.1 How much money is your organisation requesting from SKYCITY Auckland Community

Trust?This should be GST exclusive if your organisation is GST registered; GST inclusive if your organisation is not GST registered$

9.2 For this funding request detail separately the elements of expenditure.• This should total the amount of your request• GST exclusive if organisation is GST registered, GST inclusive if not GST registered

$

$

$

$

$

$

$

$ Total (should equal section 6.1) $

9.3 How much money has your organisation already raised for this project or programme?

$

9.4 Assuming this application is successful, how much more does your organisation still need to raise to complete this project?

$

9.5 If your organisation already has funds available, why are they not being used for this project?

9.6 Has your organisation applied, or do you intend applying, to another funding organisation for the same purpose? If yes, please specify.


Section 10: Your Organisation’s Finances and Non-financial performance10.1 To help us assess this application, please attach a copy of your latest financial accounts or latest audited financial accounts. Are there likely to be any significant changes to your financial situation in the next 12 months? If yes, please explain:

10.2 Please include a bank deposit slip or bank statement that matches your organisation name.

10.3 Please include statistics here as detailed in your Statement of Performance for Charities Commission requirements

10.4 Please provide figures for the following pertaining to your organisation:Annual income: Annual Expenses: Surplus/Deficit: Liquid Assets: Reserves: Investments:


Section 11: More InformationShould you be successful in receiving funding, please provide a short paragraph that SKYCITY can use to inform the public about the work that your organisation does, and what this funding will be used for (maximum 100 words)

Finally, is there anything else you think we should know about your organisation or the project? (maximum 500 words)


Section 12: Applicant Declaration• This application has the formal approval of our Board/Committee/Authority, and;• to the best of my knowledge the information provided herein and on any supplementary sheets

are true and correct, and;• that further information provided by us during the course of assessment of this application will

be true and correct, and;• we acknowledge that any decision made by the SKYCITY Auckland Community Trust is final.

We accept that no reasons for such decision will be given, nor will any correspondence be entered into, and;

• that if this application is successful, the funds awarded will be applied to the purpose as stated in Section 4 and not applied to any other purpose without the express permission of the SKYCITY Auckland Community Trust having first obtained, and;

• that any funds paid which are surplus to the stated purpose will be repaid to the SKYCITY Auckland Community Trust, and;

• that documentary evidence of the expenditure will be provided to the SKYCITY Auckland Community Trust within 30 days of the expenditure of the funds awarded.

• If this grant is successful, we will participate in the roundtable evaluation as part of the SKYCITY Auckland Community Trust’s accountability process.

By activating the ‘Signature Check Box’ you are confirming your acceptance of all clauses in this declaration.

For and on behalf of our organisation:

Signature Check Box: ☐

Name: Position: Date:


Checklist:Completed all of the questions? Checked all the figures add up?Enclosed a copy of your most recent financial accounts (audited where possible)? Enclosed copies of quotes where relevant to funding request? Enclosed a copy of your bank deposit slip or bank statement

Deadline and contact details:

Application deadline Friday 29 March 2019, 5.00pm

No late applications will be accepted

What needs to be included? Do not include documents other than what has been requested. We will contact you should we require any further information.

Contact details: Community Trust Administrator

09 363 7071

Email: [email protected]

Our preferred method of application is by email. Please send with as few PDF’s as possible. If emailing your application, please do not post an additional copy.

We will acknowledge receipt of your application by email within 48 hours.


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