Wearne Trust Application for Financial Assistance

Name
This field is for validation purposes and should be left unchanged.
ONLY APPLICATIONS SUBMITTED THROUGH THE WEBSITE APPLICATION FORM WILL BE CONSIDERED.

WRITTEN APPLICATIONS THAT ARE COMPLETED AND EMAILED WILL NOT BE CONSIDERED.
Terms of Application (Application)
1) Assessment of Applications

a. Submission of the Application does not expressly or impliedly mean that The Theodore and Isabella Wearne Charitable Trust Inc. (The Trust) has accepted the Application.
b.The Trust is under no obligation, legal or otherwise to process the Application to a successful conclusion.
c. Each application will be determined on its merits and in compliance with The Wearne Trust’s Guidelines for Financial Assistance – Organisations.

2) Liability

a. The Trust will not be responsible for any direct or indirect loss, injury, claim, liability, or damage related to the use of this site, whether from errors or omissions in the content of this site or any other linked sites, from the site being down or from any other use of the site.
b. The Trust will not be liable for any direct or indirect loss, injury, claim, liability, or damage, arising out of or related to any products, goods, or services received by the Organisation through a successful Application or any products, goods, or services provided by the Organisation to a third party with funding received from the Trust
c.The Organisation indemnifies and will keep indemnified and hold harmless the Trust from and against any direct or indirect loss, injury, claim, liability, or damage, arising out of or related to any products, goods, or services provided by the Organisation to a third party with funding received from the Trust.

3) No representations

To the extent permitted by Australian law, The Trust makes no representations or warranties in relation to:

a. any goods or services ultimately received by the Organisation through the Trust; and
b. any goods or services ultimately provided by the Organisation to a third party with funding received from the Trust.
By ticking this box I declare that I have read and have authority to agree to The Wearne Trust’s Guidelines for Financial Assistance for Organisations and I have authority to acknowledge and accept the Terms of Application on behalf of the Organisation.*
The Wearne Trust’s Guidelines for Financial Assistance – Organisations
- Yes
Privacy Policy

The Wearne Trust respects the privacy of those who apply to the Wearne Trust for assistance. Any personal information collected through this form will be collected, used and held pursuant to the Wearne Trust’s Privacy Policy.

Organisation Details
Organisation*
Organisation ABN*
Contact Name
First Last
Phone
Email*
Enter Email Confirm Email
Is the Organisation an incorporated body?*
- Yes
- No

Project/Program Details
Project/program title*
Short project/program description*
Who will be involved with the project/program?
Name
Role/Position Title
Name
Role/Position Title
Name
Role/Position Title
Name
Role/Position Title
Name
Role/Position Title
Project/Program Dates
Start Date*
DD dash MM dash YYYY
End Date
DD dash MM dash YYYY

Project/Program Details
What are the expected outcomes of the project/program?*
Describe the desired outcomes you want the project to achieve in terms of benefits for participants and/or others.
How will you know if these outcomes have been achieved?*
Describe the changes you will see if the desired outcomes of the project are achieved.
Describe the likely risks of the project/program*
Provide a short description.

Financial Considerations
Total grant amount requested from all sources*
Have you sought Government Assistance*
If yes, please attach documentation later in the application.
- Yes
- No
Provide details of other sources of funding (financial assistance) to deliver this project/program
Organisation*
Amount ($)*
Contact Name
First Last
Contact Phone*
Contact Email*
Organisation
Amount ($)
Contact Name
First Last
Contact Phone
Contact Email
Organisation
Amount ($)
Contact Name
First Last
Contact Phone
Contact Email
Organisation
Amount ($)
Contact Name
First Last
Contact Phone
Contact Email
Organisation
Amount ($)
Contact Name
First Last
Contact Phone
Contact Email
Total grant amount requested from The Wearne Trust*
Please attach relevant documentation such as quotes for items to be purchased and the most recent Annual Report for you Organisation further in this application form
Please attach relevant documentation such as quotes for items to be purchased and the most recent Annual Report for your Organisation later in the application.

Payment Details of Organisation
Preferred payment method
- EFT
- bPay
Account Name*
BSB*
Account Number*
Reference/Client Number
BPAY Biller Code*
BPAY Reference Number*
Payment details for the organisation must be included or the application will not be processed.

If another payment method is required, please contact The Trust by email at info@wearnetrust.org.au to arrange an alternative payment method.

PLEASE NOTE: RECEIPTS MUST BE PROVIDED TO THE WEARNE TRUST WITHIN 30 DAYS OF THE DATE OF PAYMENT. FAILURE TO DO SO MAY RESULT IN FUTURE APPLICATIONS NOT BEING CONSIDERED.

Organisation History
Have you previously received funding from The Wearne Trust?*
- Yes
- No
What was the total amount received?*
What was the name of the project(s)?*
Previous date(s) of funding received*

Documentation

Please scan and upload the following documents (as relevant to this application)

If documents are not uploaded your application will not be considered.
Quotes, if applicable
For each item requested two (2) quotes per item are required and should be for items of similar description. The quotes must be less than three (3) months old and include freight and installation charges, if applicable. Mitigating circumstances which prevent this may be considered by The Trust. Please note all donations paid will be nett GST unless otherwise notified with reason for including the GST in the donation.
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 16 MB.
Current financial information about the organisation
Attach most recent annual report for the organisation
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 16 MB.
Government or private assistance documentation
Evidence of other sources of funding sought both private and Government
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 16 MB.
Other Relevant Documentation
Any other relevant information such as correspondence from other charities, government departments.
Drop files here or

Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 16 MB.
Name of Person Completing Application
First Last
By ticking this box I declare that I have authority to consent to the Trust collecting the information provided in this Application on behalf of the Organisation.*
- Yes
This field is hidden when viewing the form
Date
DD dash MM dash YYYY

Step 1 of 9

Terms of Application (Application)

Privacy Policy

Organisation Details

Project/Program Details

Who will be involved with the project/program?

Project/Program Dates

Project/Program Details

What are the planned activities?

Project/Program Details

Financial Considerations

Provide details of other sources of funding (financial assistance) to deliver this project/program

Payment Details of Organisation

Organisation History

Documentation

Submission Deadlines and Approvals

Financial Assistance Applications

Contact