NQBP Community Fund Application Form

Organisation Name *

Contact's full name *

Role/position within the organisation *

Email address *

Mobile/phone number *

Postal address *

Street address *

City *

State *

Postcode *

Is your organisation registered for GST? *

YesNo

Does your organisation have an ABN? *

YesNo

If yes, please provide your ABN

Do you have public liability insurance? *

YesNo

If yes, please provide evidence (Certificate of Currency) (Upload – optional but recommended)

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About your Initiative / Project

The initiative should identify a societal or environmental need or needs in our port communities and make a real difference.

Project Name *

What is the project? *Please describe your initiative clearly. If you are seeking funding for a small part of a larger project, please make this clear.

What are the plans for your project? *Please provide more detail including the timing, location, activities, key dates/milestones, and any other important planning information.

Who will be involved and who will benefit? *Please include: • How many people will be directly involved? • How many people will benefit overall? • What types of people will be involved (e.g. young people, seniors, First Nations peoples, culturally diverse communities, people with disability, rural/regional etc.)

What community need does the project address, and what outcomes will be achieved? *Please include what success looks like and how you will know the project has made a difference.

What are the long-term benefits stemming from your initiative? *If applicable, describe any lasting benefits beyond the project end date.

Start Date *

End Date *If unknown, provide an estimated month

NQBP Alignment

Initiative must align with one or more of NQBP’s Strategic Themes and/or be directly relevant to a current NQBP project.

Which of NQBP’s strategic themes does your initiative / project / event align to / support? Select all that apply. *

Expand our current trade and servicesEnable future trade and servicesInvest in our community and surroundings

How does your initiative align with NQBP’s strategic themes and/or support a current NQBP project? *

Which NQBP value/s does your initiative best align with? Select all that apply. *

CareConnectionCourageCuriosity

Please explain how your initiative demonstrates the value(s) selected. *

Diversity and Inclusion

Initiative should be consistent with or promote the principles of diversity and inclusion.

How will your initiative be inclusive and accessible to a diverse range of people in our port communities? Please consider any that apply: First Nations peoples, gender equity, disability access, culturally and linguistically diverse communities, affordability/financial accessibility, regional access/transport barriers, safe participation (e.g. child safety, cultural safety).

Funding

A maximum of $9,500 is available per initiative.

What is the total project budget? *

What amount are you seeking from NQBP? *Maximum $9,500

Please provide a brief budget breakdown. *Itemise the key costs

Upload budget evidence (quotes, invoices, supplier estimates)

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(Upload – optional but strongly encouraged)

Have you previously received funding from NQBP? *

YesNo

If yes, please provide details.Year, initiative name, amount

Awareness

Initiative should create opportunities to raise awareness about NQBP and/or port operations.

What promotional or recognition opportunities can you offer NQBP? Select all that apply *

Provide the details of what NQBP will receive. *Please include: What the recognition is – if social media, is it Facebook, Instagram etc? where it will appear. Frequency/quantity (e.g. 3 posts, 1 media release, signage at 2 events), timeframe, estimated reach (if known).

Recognition Deliverables Summary *List the exact deliverables you commit to providing if your application is successful.

If other sponsors are involved, please provide details of confirmed sponsors.

Evaluating our partnership

Do you agree to provide a short outcome report at completion, including outcomes achieved and a basic financial breakdown? *

YesNo

Do you agree to complete an evaluation survey on completion of your initiative? *

YesNo

Supporting Evidence

Upload any supporting evidence to strengthen your application (max 5 pages or a short video link).

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Examples: quotes/invoices, letters of support, project plan, event flyer draft, maps, evidence of community need.

For security please complete the check below *

NQBP complies with the requirements of the Privacy Act 1988 (Cth) and the Information Privacy Act 2009 (Qld). By providing your personal information, you consent to NQBP using it for the purpose of administering the NQBP Community Fund and Grassroots Donation Program, and to keep you informed about future funding opportunities. NQBP will not disclose your personal information to third parties without your consent, subject to legal requirements