Grant Application Form

Grant Application Form

To encourage organisations to get involved in NBAM, Kidsafe Australia is offering small grants of up to $1000 to support organisations to deliver a project to assist us in promoting burns awareness during June.

Applications Are Now Closed.

If you meet the eligibility criteria and have read through the Terms and Conditions, please complete the application form below.

Kidsafe Australia will notify you of your application outcome by email in mid-May 2022.

If you require assistance with the application process or have any queries, please email info@kidsafevic.com.au.

Contact Person Details

Name (required)

Position (required)

Phone (required)

Email (required)

Organisation Details

Name of Organisation (required)

Email (required)

Website

ABN/ACN of Organisation: (required)

Postal Address (required)

Please describe your organisation's mission or purpose? (max 50 words)

Project, Activity or Event Details

Project/ Activities / Event Title (required)

Location of Project / Activities / Event (required) (multiple selections allowed)

Other (please specify – if international, will not be considered)

Project/ Activities / Event Details

Please provide a short description of the Project/ Activities / Event for which the Grant is sought.
(max 150 words)

Please specify your target audience
(multiple selections allowed)

Other (please specify)

What strategies will you use to promote your engagement event/s or activity? (multiple selections allowed)

Other (please specify)

What specific outcomes are expected from your Project/ Activities / Event. Please include details of expected reach. (max 200 words)

How will you measure the Project/ Activities / Event success? (max 150 words)

Project Expenditure

Income from other sources

In kind contribution

Amount requested:

Budget Breakdown

Expenditure Description

Expenditure Amount

Notes

Bank Account Details

All fields required.

Name in which your account is held:
BSB No:

Name of Financial Institution:
Account No:

Documents

Please attach all required documentation:

- Certificate of Currency and any other insurance appropriate to the activities of the proposed project

- Model Release Form/proof (as required)

By ticking this box you agree to the grant terms and conditions.
I have attached Certificate of Currency and any other relevant documents
If holding an event, we confirm that the appropriate level of public liability insurance will be arranged for the event

Thanks for your support of National Burns Awareness Month, we’ll get back to you soon!

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