VOLUNTEER MUSEUM GRANT PROGRAM
2015 APPLICATION FORM
LEG UP GRANTS
Amount Available:
Closing Date:
$50 - $500 (matched funding)
Available year round (until all funds are expended)
Name of museum/keeping place:
Name of organisation:
(if different from above)
This document must be completed in accordance with the
instructions laid out in the relevant Guidelines
This is an Arts NSW devolved funding program,
administered by Museums & Galleries of NSW
on behalf of the NSW Government
1. ACTIVITY/EVENT DETAILS
Activity Title:
Activity Start Date:
Activity End Date:
Total Amount Requested:
Please Note: the Leg Up Grant will fund 50% of your total project
amount only
(GST exclusive)
.
2. APPLICANT CONTACT DETAILS
Preferred Mailing Address:
Street / PO Box
Suburb:
Organisation’s Telephone:
State:
NSW
Postcode:
Organisation’s Website:
Name of Contact:
Position of Contact:
Contact’s Telephone:
Contact’s Mobile:
Contact’s Email Address:
Please attach the following documents to your application:
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A letter from the auspicing body who will be administering the grant (if applicable)
A copy of the program, if the activity is a conference, seminar or training course
3. ABOUT YOUR ORGANISATION
3.1 Legal Status
Please specify the organisation’s legal status:


Incorporated association
Company limited by guarantee
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Subcommittee of Council (e.g. 355 committee)
Other
If the organisation is not a legal entity such as an incorporated association or company limited by
guarantee, indicate who will administer the grant on your behalf (e.g. council):
 Letter from the auspicing body who will be administering the grant attached (if applicable)
3.2 Organisation’s Details
When was the museum established?
No of paid staff?
No of active volunteers?
Please list your paid employees, their roles at the museum and their total paid hours.
Please note to be eligible, total paid hours must be less than 70 hours per week.
NAME OF EMPLOYEE
ROLE
TOTAL PAID HOURS
PER WEEK
What are the museum/keeping place’s opening
days and hours?
How many visitors come to the museum per year?
Who owns the museum/keeping place’s building?
Who owns the museum/keeping place’s collection?
Does the museum/keeping place receive any support from your local council?
Please describe what kind of support.

YES

NO
4. ABOUT YOUR ACTIVITY/EVENT
4.1 Activity Description
Activity Description – What do you plan to do? (no more than 200 words)
In the space below, or in an attached document, please outline:

Who is undertaking this activity?

What is their role at the museum?

How long have they been volunteering at the museum?

What does the skills development activity involve? (For example, are your volunteer/s
attending a workshop or seminar, or spending time at another museum developing skills?)

How will this skills development activity benefit your museum?

A significant outcome of a skills development opportunity is the sharing of newly acquired
skills and knowledge with your museum colleagues. Please give a specific outline of how
you plan to share these skills and knowledge with your museum colleagues? This may be a
talk, presentation, or a paper that you write for the museum.
4.2 Brief Activity Summary
Activity Summary (no more than 50 words)
(For example, to send Museum of Pineapples volunteers Joe Smith and Ann Jones to a Significance
Assessment Workshop)
This summary will appear on all official documents related to the grant
4.3 Activity Budget
If travelling by car, estimate the total distance to be travelled in kilometres, and calculate your
costs at a rate of 63 cents per kilometer for the distance travelled:
Distance:
at 63c/km = $
Where will you be staying? (Please name
the accommodation as well as the town)
Use the table below to find the relevant funding cap for accommodation:
Sydney:
$170 Regional centre: Albury, Armidale, Bathurst, Broken
Other capitals range
Hill, Coffs Harbour, Cooma, Dubbo, Gosford, Goulburn,
from $120-$170. Ask
Gunnedah, Maitland, Mudgee, Muswellbrook,
M&G NSW the rate.
Newcastle, Nowra, Orange, Port Macquarie, Tamworth,
Tumut, Wagga Wagga, Wollongong
High cost regional:
Bourke, Norfolk Island
$170 Any other regional:
$140
$110
Please provide a budget using the sample budget below as a guide (you may add extra lines to the
table if needed). Use the accommodation allowance amount and your calculated car use amount.
All non-car travel costs must be expressed in GST exclusive amounts.
SAMPLE BUDGET
EXPENSE (example only)
COST
COST
$40.00
Seminar fees
Car travel, 340kms @ 63c per km
$214.20
2 nights accommodation at
Examples Hotel in Mudgee $163 a
night - capped @ $150 per night)
$300.00
TOTAL COST
Amt provided by your organisation
(must be at least 50% of total cost)
Amt requested from Leg Up Grant
(no more than 50% of total cost)
TOTAL COST

YOUR BUDGET
EXPENSE
$554.20
$277.10
$277.10
$554.20
TOTAL COST
Amt provided by your organisation
(must be at least 50% of total cost)
Amt requested from Leg Up Grant
(no more than 50% of total cost)
TOTAL COST
Is your organisation registered for GST?
Please attach the following documents to your application:
 a copy of quotes or a screen shot of advertised prices to support the budget (for every item
excepting car travel)
5. APPLICATION CHECKLIST

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
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
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All sections of the Application Form completed (including the budget)
Application signed by an authorised person from the organisation
Attached letter from the auspicing body who will be administering the grant (if applicable)
Attached program or flyer from the activity you will be attending
Attached quotes or screen shots of process to support your budget for accommodation, fees
and transport (excepting car travel)
Attached letter of support from your museum, historical society or council outlining how the
skill development activity will benefit you the applicant and the museum. Included in this
letter from your museum must be an agreement to fund 50% of the costs associated with
the skill development activity
Attached budget for activity/event (if the application relates to an event you are hosting)
Any other documentation associated with the activity that will support your application
TERMS & CONDITIONS
Applicants should be mindful of the following terms and conditions associated with accepting a
Volunteer Museum Grant. These include:
 All monies must be expended as per the approved application
 Unused monies must be reported to M&G NSW and returned in the proper manner (please do
not send in a cheque before discussing the matter with M&G NSW)
 Successful applicants will be required to provide an acquittal report within two months of the
project’s completion. The acquittal report includes a one page report to be written by the
applicant on an overview of the project, and the resulting benefits to the museum, and/or the
individuals involved in the project. Photographs, media clippings and brochures should be
included in the acquittal documentation where available. M&G NSW may use all or parts of
this report in marketing material for the VIM Grant Program
 M&G NSW and Arts NSW must be publicly acknowledged as supporting the project by using the
appropriate logos and text acknowledgement on all printed and/or electronic material
produced in relation to the funded activity. This includes publications, invitations, banners,
websites and any printed or electronic material. Any products developed as a result of the
funded activity must also carry the M&G NSW and Arts NSW logos and acknowledgments.
 All acknowledgements that accompany the Arts NSW logo must use the following wording:
This project is supported by Arts NSW’s Volunteer Museum Grant Program, a devolved funding
program administered by Museums & Galleries of NSW on behalf of the NSW Government.
 The logos and written acknowledgement should be placed in a position appropriate to the level
of support. Logos and style-guides are available from the M&G NSW Information and
Resources Officer on 02 9339 9902 or email comms@mgnsw.org.au.
6. DECLARATION BY APPLICANT – SIGN OFF SHEET
Please note: Please sign and scan this page separately and submit along with a text
searchable version of your application form and project description.
I have read the guidelines relating to the grant program. I certify that, to the best of my knowledge,
all the information in this application is correct and has been approved by the board of
management or equivalent body, and that I have the delegated authority to sign this application.
I have read and agreed to the terms and conditions associated with this grant (see below).
I acknowledge that M&G NSW has the right to withdraw the offer of funding or demand the return
of funds already paid if it is discovered that any of the information provided is false.
Name of authorised person:
Position of authorised person:
Signature of authorised person:
Date:
Museums & Galleries of NSW prefer grant applications to be sent by email.
Please email your application on, or before the closing date to:
margots@mgnsw.org.au
If you are unable to email the supporting documentation you must inform
M&G NSW and send the package to:
Volunteer Museum Grant Program
Museums & Galleries of NSW
Level 1, 10 Hickson Rd
The Rocks NSW 2000