Town of Cambridge
1 Bold Park DrivePO Box 15
FLOREAT WA 6014
Email: mail@cambridge.wa.gov.au
INDIVIDUAL ACHIEVEMENT GRANT
Application Guidelines
INTRODUCTION
The Town is pleased to offer financial assistance to individuals in recognition of excellence in
sport, leisure, cultural and educational activities.
This program is designed to offer travel assistance to individuals who have been selected to
represent the State or Nation in interstate or overseas championships and competitions.
Applicants may be awarded $100 toward travel expenses for interstate travel or $500 for
overseas travel.
SELECTION CRITERIA

applications are invited from Town of Cambridge residents only

applicants must be selected to represent Western Australia or Australia

applicants who have demonstrated initiative and endeavour in raising funds for themselves
will be favourably considered

applications must be made in writing on the attached application form

application forms must be completed in full

no more than one application will be received each calendar year from any individual

applications will not be considered where travel costs are fully reimbursed by another
body

those applications not of a competitive nature will be assessed individually and approval is
at the discretion of the Chief Executive Officer

should the applicant fail to attend the championship or competition, Council funds must be
promptly returned

applicants must fill in a feedback form after the championship or competition to be eligible
for further funding.
Town of Cambridge - Individual Achievement Application Form and Guidelines
Page 1
Application Form
Personal Details
Name: _____________________________________________________________________
Address: ____________________________________________________________________
Email: ______________________________________________________________________
Telephone: __________________________________________________________________
Mobile: _____________________________________________________________________
Championship/Competition Details
What local club/organisation will you represent?
___________________________________________________________________________
Please indicate the following details about the championship or competition:
Name of championships
Date of championships
Place of championships
Age group to be represented
Have you previously represented Western Australia or Australia?
Yes
No
Yes
No
Date and place of championship
Date and place of championship
Date and place of championship
Did the Town provide financial assistance?
Town of Cambridge - Individual Achievement Application Form and Guidelines
Page 2
Financial Details
Please complete the following budget details in full:
$
Income
Applicant contribution
Town’s contribution ($100 or $500)
Other contributions (please specify)
Total $
Expenditure
Airfare
Uniform
Accommodation
Transport
Sundries
Total $
Have you undertaken any programs to fund raise toward the trip?
Yes
No
Please Specify below:
Town of Cambridge - Individual Achievement Application Form and Guidelines
Page 3
ENDORSEMENT
I certify that the information submitted by _______________________________________
(applicant’s name) is true and correct and that the ________________________________
__________________________________ (organisation’s name) supports the application.
Name
______________________________________________
Position in organisation: ______________________________________________
(Chairperson / President / Authorised Person)
Signature
______________________________________________
Date
_______________________
Telephone (daytime)
_______________________
Applications addressed to
Mr Jason Buckley
Chief Executive Officer
Town of Cambridge
PO Box 15
FLOREAT WA 6014
Town of Cambridge - Individual Achievement Application Form and Guidelines
Page 4