Auspice Organisation Authorisation Form

Auspice Organisation Details

Auspiced Group Details

How long have you been involved with the auspiced group? ___________________________________

What have your involvement consisted of? ____________________________________________________________________________________

____________________________________________________________________________________

Declaration

A person with authority from the auspicing organisation is required to sign this application and certify the followings:

□  I certify that all details supplied in this application form and in any attached documents are true and correct to the best of my knowledge.

□  I have read the Community Grants Program Guidelines and understand the responsibilities of my organisation and the group it is auspicing.

□  I am authorised by the group to sign this declaration.

□  I will contact Brimbank City Council immediately if any information provided in this application changes.

Name: ____________________________________________________________________________

Position: ___________________________________________________________________________

Signature: __________________________________ Date: __________________________________

Note:

Auspice organisations help small or new organisations who are not incorporated, or who do not have an ABN, to access grant funds. An auspice organisation must be a not-for-profit organisation, have an ABN and Public Liability Insurance. They accept legal and financial responsibility for the grant if successful. Applications can be submitted directly by groups being auspiced. However, the funding agreement for successful grants will be made between the auspice organisation and Council. The grant money will be paid directly to the auspice organisation. All applications through auspice organisations need to submit an Auspice Organisation Authorisation Form at the time of grant application.

Privacy Statement

Council is committed to protecting the privacy of personal information it holds. Any personal information collected is used for the purpose of administering Council’s grants program, including an assessment of whether the applicant is eligible for funding, subsequent evaluation of a funded activity, and the auditing of grant funds (which may be undertaken by or on behalf of Council or any government inspection agency)