Peel -Ha r vey Com munit y En vironm ent Grant s
Changing Landscapes
Expression of Interest Form ($10,001-$50,000)
In completing this form please ensure you refer to the Guidelines.
Type your responses directly into the ‘boxes’ following each question.
1.
Project Title
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Total project budget:
$Click here to enter text.
Grant amount requested:
$Click here to enter text.
Project start date:
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Project completion date:
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Please submit your EOI by 10am, Thursday, 12 November, 2015:
By mail or in person
By email
PHCC Community Environment Grants
Attention: Community Environment Grant - Application
EOI
Peel-Harvey Catchment Council
admin@peel-harvey.org.au
58 Sutton Street
MANDURAH WA 6210
Successful EOI applicants will be invited to submit a Grant Application which will be due by 10am
Monday, November 30, 2015
OFFICE USE ONLY
Date submitted
Pre-eligibility done by
Date
Amount applied for
$
EOI. No.
App. contribution
$
Notification
This project is supported by the Peel-Harvey Catchment Council, through funding from the Australian Government’s National Landcare
Programme.
Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
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2.
Applicant details
Name, Community Group
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or Business Name: (Legal
Entity)
ABN
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Landowner:.
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Organisational Status
e.g. Incorporated group
Registered for GST
Yes ☐
No ☐
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Postal address
Contact
person
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for
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application
Position in organisation
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Telephone
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Email
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Person
sign
Authorised
on
behalf
to
Mobile
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of
Organisation
Are any proposed actions within your project, a requirement of an existing Approval?
Yes ☐
Is your group incorporated, a school or a local government council?
Yes ☐
No ☐
Does your group have an Australian Business Number?
Yes ☐
No ☐
No ☐
If you answered no to either of these questions you will need a sponsor.
3.
Sponsor organisation (if applicable)
Name
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Postal address
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Contact person
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Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
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Position in organisation
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Telephone
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4.
Email
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Insurance
Do you/ does your group have current public liability insurance?
☐ Yes
☐ No
Do you/your group have current workers compensation insurance?
☐ Yes
☐ No
☐ N/A
☐ Other:
Do you/your group have current personal accident insurance for volunteers?
☐ Yes
5.
☐ No
☐ N/A
Project site - Location:
General location
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(street address, lot numbers)
Who owns the land?
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Who manages the land?
What natural asset/s are you
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protecting?
Local
Government
(councils)
covered
area/s
by
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the
project
GPS coordinates (if available)
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Please attach a map showing the location of the project site, anticipated project activities and any works already
undertaken in the area. If work is being undertaken at multiple sites please include a map of each site and an
overarching map showing the sites in relation to each other.
6.
Project Description
Provide a description of the project (approx, 500 words maximum) including:

why the project is important – alignment with National, Regional & local objectives; addressing
recommendations from Plans/Strategies etc

what natural asset/s are you protecting and what are the threats you are addressing for that asset and
the long-term risk if nothing is done

what the project will do (activities of your project)
Note: you also need to complete Q9 and the project budget (Q8)
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Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
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7. Alignment with other plans
Is the proposed project in accordance with a Management Plan? Yes ☐
No ☐
If Yes, please name the Plan(s).
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If No, will a management plan be prepared to support this project? Yes ☐
8.
No ☐
Partnerships, Consultation and Permissions
Please indicate what partners you expect to be involved in the project; what consultation with the Aboriginal
Community will be done as part of project planning and delivery, and any approvals you have identified as
likely to be required to undertake the project.
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9.
Addressing Priorities
Please identify which items in each of the following categories your Projects will address:
A
NLP objectives:
Please tick where appropriate the NLP objectives that the project will address and indicate estimated hectares
that will be managed.
1.
B
The project will protect, improve or maintain 1.1
Regionally significant species habitat or communities
☐
No. Hectares:
1.2
Habitats for migratory species
☐
No. Hectares:
1.3
Habitats for threatened species
☐
No. Hectares:
1.4
Threatened ecological communities
☐
No. Hectares:
1.5
The ecological character of the Peel-Yalgorup Ramsar site
☐
No. Hectares:
Peel-Harvey’s NRM Strategy
Please indicate below which of the Activities from Bindjareb Boodja Landscapes 2025 the project will address:
Goal/strategy
Strategy
Activity
B1 Wetlands and
B1.2 Improve condition
B1.2.1 Prepare and implement action plans to
Waterways are
of wetlands and
restore the natural function of wetlands and
healthy and
watercourses
watercourses
productive
B1.3 Protect wetlands
B1.3.2 Encourage implementation of management
and watercourse
plans
B3 Coastal and
B3.1 Protect foreshores
B3.1.2 Support the community to value and manage
nearshore areas and
for their ecological and
coastal areas

recreational values
Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
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processes are
resilient and valued
B4 Biodiversity is
B4.1 Protect priority
B4.1.3/B4.1.4 Assist land managers to protect
conserved
terrestrial and aquatic
priority natural areas – terrestrial and aquatic
natural areas
B4.2 identify and
B4.2.1 identify and monitor threats and threatening
monitor threats and
processes
threatening processes
B4.2.2. implement and support threat reduction
activities in priority areas
C
B4.3 Restore ecological
B4.3.1 undertake landscape scale restoration for
linkages
multiple benefits
Threats
Please indicate which threats to terrestrial biodiversity, aquatic biodiversity and water resources identified in
Binjareb Boodja Landscapes 2025 that the project will address.
☐ acidification
☐ altered fire regimes
☐ contamination
☐ erosion
☐ eutrophication & sedimentation
☐ fragmentation & isolation (loss of native vegetation)
☐ grazing
☐ impacts of climate change – sea level rise; drought; altered water regimes; reduction in flow
☐ inefficient use of water resources
☐ loss of riparian zone/buffers
☐ pathogens (phytophthora)
☐ physical disturbance (including of seagrass beds, sediment and benthic layers)
☐ recreational impacts
☐ salinity
☐ weeds & other invasive species (including feral animals)
D
Activities
The eligible activities below are the National Landcare Programme’s minimum requirements for project
monitoring and reporting. Which Activities will your project undertake? Please tick
Activity Name

Activity Name

Activity Name
Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes

Activity Name

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Debris Removal
Fencing
Seed Collection
Weed Mapping &
Monitoring
Disease Management
Pest Management
Site Preparation
Erosion Management
Revegetation
Weed Treatment
Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
Other:
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10. Project Budget
Please indicate the Activities & Actions the project will undertake, the costs involved and funding sources. (All
costing to be shown exclusive of GST)
An example activities is provided in grey text.
Activities & Actions
Start
Finish
Total cost
Co-
P-H Grant
Describe what you will achieve
MM/YY
MM/Y
$
contributions
$
Y
(ex GST)
(cash and in-
(ex GST)
kind)
$
(ex GST)
Example:
Fence
1ha
of
degraded
TEC
vegetation on School land to control illegal
Mar
Mar
$5 000
-
$5 000
2015
2015
$3 300
$3 300
-
Totals
$
$
$
access
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Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
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11. Other funding
Has a funding application for this project, or elements of the project, been submitted for a different grant
such as State NRM Community Action Grants? Please name the grant.
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Is this a continuation of an existing project? Yes ☐
No ☐
12. Any additional information relevant to this EOI
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13. Where did you hear about this grant program?
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14. Declaration
I/we declare that the information provided on this form is complete and correct to the best of my knowledge. I
understand that the EOI does not guarantee funding and that the Peel-Harvey Catchment Council reserves the
right to invite EOI applicants to submit a full Application based on the selection process.
Signature of Applicant
Print Name
Date
* Where the applicant is not the landowner, the applicant must seek permission from the landowner/vesting
authority to undertake these works.
Signature of Landowner
Print Name
Date
Before submitting your EOI, please make a copy for your records.
Peel-Harvey Community Environment Grants – Round 1 Changing Landscapes
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