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About
Contact
Donate
How We Help
info@52degreefoundation.org
phone: +6127257 5252
Community Grant Application Form
Community Grant Application Form
Please read the guidelines before commencing an application.
About Your Organisation
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School or Organisation Name
School or Organisation Street
School or Organisation Suburb
School or Organisation Postcode
What best describes your Organisation type?
School
Support Organisation
Community Group
Government Agency
Private Business
How many Children do you support (17 Years Old and under)?
Brief Description of Organisation
What types of special needs or disadvantage do you cater for?
How many Children have special needs?
Are any Children who will benefit of Aboriginal or Torres Strait Islander origin?
Yes
No
Age Range of Children you assist*
0 - 3
4 - 6
7 - 12
13 - 15
16 - 18
About You
First Name
Last Name
Job Title
Preferred Email
Personal
work
Email
*
Preferred Phone
Mobile
Work Phone
Phone Number
Your Community Project
Equipment Required / Project Title
Details of the project
What are the Benefits and expected outcomes
Total Equipment Cost
Number of Children who will benefit from grant
Number of years equipment will last
Requested Amount
Are you able to make any financial contributions?
*
Yes
No
Other Funding Sources
Other Funding Source Name
Amount
What is the Status of this other funding? Confirmed or Pending?
Submission Letter
A submission letter is an opportunity for you to tell us in detail about your project and why you need funding. The letter should be on letterhead, signed and dated and contain the following as a minimum
* Contact details of the authorised representative and organisation
* Details of the benefit to children and staff, and, if applicable, families and wider community
* Why the equipment is required and what need the equipment will address
* Details of the requested item including supplier information
* Information related to the expected outcomes and measurements
Upload Submission Letter
Are you applying for Sensory items?
Yes
No
If applying for sensory items please upload DET Equipment Prescription and Use of Sensory Room Statements (File size up to 5MB allowed)
Quotes
You must supply three (3) quotes, unless there is only one supplier.
Quote 1 (File size up to 5MB allowed)
*
Quote 2 (File size up to 5MB allowed)
Quote 3 (File size up to 5MB allowed)
Who is your preferred supplier?
Consent
How did you hear about 52 Degree Foundation?
52 Degree Foundation website
Social media
Press
Referee
Word of mouth
School
Other
How did you hear about 52 Degree Foundation - Other
Previously received assistance?
Yes
No
How easy was the form out of 10?
1
2
3
4
5
6
7
8
9
10
How long did the application form take to complete?
I consent to 52 Degree Foundation Victoria collecting the information provided in this application. I have read and agree to52 Degree Foundation guidelines. I understand that if I do not provide the information requested, I may be ineligible to receive assistance from 52 Degree Foundation Victoria
I want to receive Grant Notifications?
I want to receive 52 Degree Foundation Heartbeat Newsletter?
Previous Equipment Funding
Application Reference
What was the Equipment or Project Name?
Date Previous Funding Recieved
Submit