Creative Communities Scheme Application

Before you Begin

Read the Creative Communities Scheme Application Guide

Before you prepare your application you should read the Creative Communities Scheme Application Guide. This guide tells you:
 whether you are able to apply for Creative Communities Scheme funding for your project
 which projects and costs are eligible and ineligible
 what information you will need to include in your application

Complete the Creative Communities Scheme Application Form

 Applications can only be submitted using this form or the physical version of it. (Creative Communities Scheme Application Form)
 Type your answers to each question in the boxes provided.
 If you need more space, type your answer into a separate document and upload it in the Supporting Information section at the end of the form. Please include the section headings to help assessors.
 We will email you a copy of your completed application for your own reference.
 Contact the CCS administrator if you need advice on your application (see contact details below).

CCS Administrator
Matamata-Piako District Council
P.O.Box 266, Te Aroha 3342
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Phone: 07 884 0060

Click here to Begin your Application

Applicant Details

Are you applying as an individual or a group?*

Individual

Group

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Full name of applicant:*

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Contact person (for a group)

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Street address*

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Suburb*

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Post code

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Town/City*

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Email*

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Daytime telephone

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All correspondence will be sent to the above email or postal address.

Name on Bank Account: *

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Is your organisation GST registered?

Yes

No

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GST Registration Number: *

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Bank Account Number: *

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If you are successful your grant will be deposited into this account.

Ethnicity of Applicant/Group:
(Choose all that apply) *

Please Specify:

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Project Details

Project Name: *

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Brief Description of Project: *

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Project Location, Timing and Numbers

Venue and Suburb or Town: *

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Start Date: *

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Number of Active Participants: *

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Finish Date: *

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Number of Viewers/Audience Members: *

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Please ensure all fields have been filled and all details are correct before advancing to the next page.

Continue to the Project Details Page:

Project Details

The Idea/Te Kaupapa:
What do you want to do?

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The Process/Te Whakatutuki:
How will the project happen?

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The People/Ngā Tāngata:
Tell us about the key people and/or the groups involved.

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The Criteria/Ngā Paearu:
Tell us how this project will deliver to your selected criterion: access and participation, diversity or young people.

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Please ensure all fields have been filled and all details are correct before advancing to the next page.

Continue to the Budget Details Page:

Financial Information

Please fill out this template spreadsheet with information about your project's costs, incomes, and any other financial assistance you have received for this project.

Once you have filled out the template, upload it in the field below.

Are you GST Registered? *

Yes - Do NOT include GST in your budgetNo - Include GST in your budget Required Input

Total Cost Amount

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Total Income Amount

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Costs Less Income - This is the maximum amount you can request from CCS

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Amount you are requesting from the Creative Communities Scheme *

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Upload your completed spreadsheet here:

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Other Financial Information

Groups or organisations must provide a copy of their latest financial statement. This can be a copy of the audited accounts an income and expenditure statement or a copy of the unaudited management accounts. You can upload these documents in the Supporting Information section of this form.

If your group or organisation has reserves which are not being used for this project you should include your reserves statement or policy. You can upload these documents in the Supporting Information section of this form.

Please ensure all fields have been filled and all details are correct before advancing to the next page.

Continue to the Other Financial Information Page:

Supporting Documents

If you have any other documentation to support your application or you required more space that was provided, you can upload these here.

If you have more than one document, please put all your documents into a single .zip file and upload that file.

Upload Supporting Documents Here

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Declaration

You must read and agree to the following. Tick the box at the end to show that you have read the information and agree to the conditions.

I/We understand that if this application is successful I/we cannot receive funds for the same project from Creative New Zealand’s other funding programmes.
I/We declare that the details contained in this application are correct and that I/we have authority to commit to the following conditions.

If this application is successful, I/we agree to:

complete the project as outlined in this application (or request permission in writing from the CCS Administrator for any significant change to the project)
complete the project within a year of the funding being approved
complete and return a project report form (this will be sent with the grant approval letter) within two months after the project is completed
return any unspent funds
keep receipts and a record of all expenditure for seven years
participate in any funding audit of my organisation or project conducted by the local council
contact the CCS administrator to let them know of any public event or presentation that is funded by the scheme
acknowledge CCS funding at event openings, presentations or performances
use the CCS logo in all publicity (eg poster, flyers, e-newsletters) for the project and follow the guidelines for use of the logo. Logo and guidelines can be downloaded from the Creative New Zealand website: http://www.creativenz.govt.nz/about-creative-new-zealand/logos
I understand that the Matamata-Piako District Council is bound by the Local Government Official Information and Meetings Act 1987
I/we consent to Matamata-Piako District Council recording the personal contact details provided in this application, retaining and using these details, and disclosing them to Creative New Zealand for the purpose of evaluating the Creative Communities Scheme.
I/we understand that my/our name and brief details about the project may be released to the media or appear in publicity material.
I/we undertake that I/we have obtained the consent of all people involved to provide these details. I/we understand that I/we have the right to have access to this information.

This consent is given in accordance with the Privacy Act 1993

I have read the above information and agree to all sections. Required Input

Name of Contact Person/Applicant: *

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Date: *

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I declare that all the information I have entered is true and accurate. * Required Input

I acknowledge that invoices will be processed and paid the month after they are received by Council * Invalid Input

All applications by person/s under the age of 18 must be signed by applicant’s parent or legal guardian:

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Date:

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Is this application complete? All fields marked with a * must be filled.*

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Incomplete applications will be declined.

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