Part 1: Application Information
If yes, please provide ABN in the following box.
If yes, please let us know which financial year funding was received in the following box.
Part 2: Bank Account Details (Council's preferred method of payment is EFTPOS.)
Funds will only be made to organisations not individuals. Please provide bank account details for direct deposit if funding is approved.
Part 3: Grant Request
If you answered no, please make sure you fill out a Venue Lodgement / Hire Booking Form.
If yes, please provide the following details in the spaces below.
Please provide details.
Important: Alignment with the Community Strategic Plan (Please refer to Table 3 in Financial Assistance Program Application Guidelines)
As part of the general criteria for evaluating requests for financial assistance, groups and organisations must identify how the request links to the strategies and objectives in the Community Strategic Plan.
Part 3: Declaration
I have read the guidelines relating to the Grant Request and certify to the best of my knowledge the information provided in this submission is true and correct and that the application has been submitted with the full knowledge and agreement of the Group/Organisation applying.
Privacy and Personal Information Protection Notice
We are collecting this information to process your request. We may not be able to do so without it. Supplying this information is voluntary and it will not be used for any other purpose without seeking your consent. We will store your personal information on our systems or in our offices, where it will be used by our staff and contractors. Other people can request access to it under the Government Information (Public Access) Act 2009. You can ask us to suppress your personal information from a public register and we will consider your request in line with the Privacy and Personal Information Protection Act 1998. Our Privacy Management Plan sets out how you can access or correct your personal information. Please visit www.wentworth.nsw.gov.au for a copy of the plan.