NSS Supporting Communities Program

Eligibility Criteria

1. Must be within a community in which NSS operates.
2. Demonstrates the ability to execute the proposed project/activity in a professional and timely manner.
3. Outlines the needs and requirement for the project/activity within the community.
4. Identify what the direct benefit to the local community will be.
5. Program/Activity must have clear objectives set and be executed within the relevant funding round timeframe.

Application Periods

Round 1:

• Opens 1st May
• Closes 31st July
• Select for funding after July

Round 2

• Opens 1st November
• Closes 31st December
• Select for funding after December

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Date Submitted *

Funding Round *

• Round 1 – For funding July-December
• Round 2- For funding January-June

What is the timeframe of the program/activity? *

Name of Applicant *

Company/Organisation *

PART 1 – ABOUT THE APPLICANT

Is the Applicant a not-for-profit *

• Yes
• No

ABN

Type of Organisation (as per ABN Registration)

Is the Applicant registered for GST

• Yes
• No

Website Address *

Contact Person *

Role *

Phone Number *

Email Address *

Has the applicant previously received support from NSS? If yes, please provide further details:

• What support was received?
• When was the support received?

Has the applicant previously received community support from NSS? If yes, please provide further details:

PART 2 – SUPPORT REQUEST

Name of Program *

Location of Community *

Please provide details of the program/activity in which you are applying for support? – Include the following:

• Objective/s
• What the community benefit is?
• Why NSS should provide support?

Please provide details of the program/activity in which you are applying for support? – Include the following *

How will the community benefit from the program/activity? *

What support are you applying for? *

• Financial
• In-Kind
• Volunteer

In the event of an emergency, does your organisation have the necessary insurance coverage and first aid facilities in place? *

• Yes
• No
• Other

Please enter what other insurance coverage/first aid facilities are available:

Please provide details of the type and total value of support you are applying for? *

How much financial support are you seeking? *

• $0 – $1,000
• $1,000 – $3,000
• $3,000 – $5,000
• $5,000+
• $10,000+

How will the support from NSS be acknowledged? *

PART 3 – DECLARATION

I have the authority to submit this application on behalf of the organisation specified in section 1 of this Application form.

I declare that to the best of my knowledge that the information contained within this application form is true and correct.

Name *

First

Last

Title / Role *

Date *

Submit