GRANT APPLICATION FORM

DATE OF APPLICATION *

APPLICANT (Name, if an individual, or Organisation Name) *

APPLICANT OR KEY PROJECT CONTACT DETAILS (address, phone) *

OTHER APPLICANT OR KEY PROJECT CONTACT DETAILS (address, phone)

EMAIL ADDRESS *

OTHER APPLICANT'S EMAIL ADDRESS

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Project Overview

PROJECT TITLE *

SHORT DESCRIPTION OF PROJECT (provide a short summary of the project) Word count: 200 words *

TIMELINE

Start date *

End date *

Detailed Timetable

AMOUNT SOUGHT (including GST) *

WILL THE APPLICANT RECEIVE OTHER FUNDING FOR THIS PROJECT? *

YESNO

IS THE APPLICANT REGISTERED FOR GST *

YESNO

INDICATE THE APPLICABLE OBJECT/S OF THE LAW FOUNDATION

The objects and purposes of the Foundation are: *

(a) To promote or undertake legal research which in the opinion of the Foundation may be of value in the reform of law.(b) To promote and provide legal education including the education and training of legal practitioners and persons employed by legal practitioners.(c) To promote or undertake community education in law and the legal system, including programmes in schools.(d) To communicate to legal practitioners and other persons, information on the law and matters relating to the law.(e) To publish, subsidise or otherwise assist in the publication of materials relating to, resulting from or connected with carrying out the objects of the Foundation.(f) To provide legal services to the community or a section of the community.(g) To do anything incidental or conducive to the carrying out of the foregoing objects.

Project Description

WHAT IS THE PURPOSE OF THE PROJECT OR ACTIVITY (e.g. what is it trying to achieve and why) Word count: 200 words *

WHAT IS THE LEGAL NEED? (provide evidence in support) Word count: 200 words *

WHAT ARE THE KEY PROJECT ACTIVITIES? (describe how the project design/activity supports the purpose and intended outcomes) Word count: 200 words *

WHAT EXPERIENCE/EXPERTISE DOES THE APPLICANT HAVE TO DELIVER THE PROJECT? (this could be previous work/activity with a community group or area of law) Word count: 200 words

HOW WILL THE APPLICANT ENSURE THE PROJECT MEETS THE NEEDS OF THE INTENDED BENEFICIARY/BENEFICIARIES? (this could be in terms of design, format and dissemination) Word count: 200 words

Project Success and Outcome/s

HOW CAN SUCCESS BE MEASURED FOR THIS? WHAT WILL BE A SUCCESSFUL OUTCOME/OUTCOMES? (what are the intended outcomes?) Word count: 200 words *

WHAT TOOLS OR TECHNIQUES WILL THE APPLICANT USE TO DETERMINE IF THE OUTCOME/OUTCOMES HAVE BEEN ACHIEVED? (e.g. feedback forms, surveys) Word count: 200 words

Budget

Please include all income and expenditure for the project. Income and expenditure totals should balance.

Income should be itemised and may include:

* the amount the applicant is requesting from the Foundation
* other grants (if applicable)
* cash contributions from the applicant
* in-kind contributions

Expenditure should be itemised. Budget items may include the following:

* a breakdown of salaries * travel * equipment
* stationery * printing * postage/advertising/promotion
* other purchases of equipment * travel
* data processing/user testing evaluation

If the Budget below is insufficient, please upload your own Budget here

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Income Source

Income Amount

Other Income Sources

Other Income Amount

TOTAL INCOME

Expense for whom and what purpose

Expense Amount

Other Expense

Other Expense Amount

Other Expense (2)

Other Expense Amount (2)

Other Expense (3)

Other Expense Amount (3)

Other Expense (4)

Other Expense Amount (4)

Other Expense (5)

Other Expense Amount (5)

Other Expense (6)

Other Expense Amount (6)

Other Expense (7)

Other Expense Amount (7)

Other Expense (8)

Other Expense Amount (8)

Other Expense (9)

Other Expense Amount (9)

TOTAL EXPENSES

UPLOAD THE CURRICULUM VITAE OR RESUME OF THE PERSON OR PERSONS WHO WILL BE PRIMARILY RESPONSIBLE FOR CARRYING OUT THE PROJECT *

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UPLOAD OTHER DOCUMENTATION IN SUPPORT

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REFEREE (1) NAME AND ADDRESS DETAILS *

REFEREE (2) NAME AND ADDRESS DETAILS *

Please verify *

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