AUSTRALIAN INSTITUTE FOR THE CONSERVATION OF CULTURAL MATERIAL INC.
GPO Box 1638 CANBERRA ACT 2601
2014 Application Form
AICCM Queensland Inc PROFESSIONAL
DEVELOPMENT GRANTS UP TO $450
CLOSING DATES AND NOTIFICATION
Closing date for AICCM Q Professional Development Grant application is 1 July 2014. Applications will be
accepted for events occurring more than 5 weeks, but less than 12 months from the application date.
Applicants are advised of the outcome within four weeks of the application date
SELECTION PROCESS
The applications will be reviewed and a final decision made by the AICCM Q Professional Development
Committee. Applications are assessed against criteria including: appropriateness of the event to furthering
the applicant’s professional development; qualifications of the applicant; the applicant’s demonstrated
involvement in AICCM Q and their ability to publish/lecture on the event to the benefit of members; previous
funding received by the applicant from AICCM Q Professional Development Fund; limited other financial
assistance available for the program (including workplace funding); completeness of application and
compliance with eligibility criteria below.
ELIGIBILITY
 Professional development grants support activities and opportunities that will significantly develop and
advance your professional knowledge and skills
 Applicants must be Queensland residents
 Applicants must be individual AICCM Q members of 5 years standing

Applicants must provide a follow up lecture/workshop to AICCM Q members and a written
review/article for the AICCM National Newsletter within the financial year
 Funding can support attendance at AICCM and non-AICCM organised events
 Applicants are reminded that they should not make any financial commitment in the expectation that
they will receive funding.
 Should the professional development activity be cancelled or delayed, or the funded participant is
unable to attend, all money must be returned to the AICCM Q.

A final report is to be submitted to AICCM Q within 30 days of the event completion. Final Report
Forms are available from AICCM Q Secretary.
OFFICE USE ONLY
Application no: ____________________________
Applicant name: ____________________________________________________________________
AICCMQ Professional Development Grants 2013-4
1. ABOUT THE APPLICANT
1.1 Applicant details
Mr
Title:
Ms
Other (please specify):
Given names:
Family name:
Job title and employer

Go to 1.2
1.2 Contact details
Street address:
Suburb/town:
State:
Postcode:
Postal address:
(If the same as your street address, write ‘as above’.)
Suburb/town:
Telephone: Work
State:
(
)
Mobile:
Home:
(
)
Postcode:
Fax:
(
)
Email:
Website address:
Have you applied for an AICCM Queensland PD grant before?
Yes
No
If yes, under which name?

Go to 1.3

Go to 2.1
1.3 AICCM Membership details
AICCM membership
number
Queensland member since DD/MM/YYYY
Ordinary Member
AICCMQ Professional Development Grants 2013-4
Professional member
2 PROFESSSIONAL DEVELOPMENT PROPOSAL
2.1 Proposal summary
GRANT FUNDING REQUEST:
Your application will NOT BE
ELIGIBLE if your proposal
begins less than five weeks from
the application date
(Use whole dollars only)
$
START DATE for proposal
DD/MM/YYYY
FINISH DATE for proposal
DD/MM/YYYY
Proposal title:
Please outline your proposal (please do not refer to attachments) (MAX 1400 words)
Please include:
 what you plan to do
 where and when will it take place (including a programme if available)
 why this is a good/unique opportunity for you
 the significance of this proposal for your career
 how you will use the AICCMQ PD grant money
The funding will be used towards
Where will your proposal happen?
Please include institution (if relevant), town, city or country if overseas (e.g. Bundaberg,
Perth)

Go to 2.2
2.2 Outcomes/ Benefits to Conservation profession/community in
Queensland. Please describe how you plan to feedback to AICCM Q members.
(Note: An Outcome Report, including financials, 1-2 pages in length will also be required 30 days after event to
acquit the grant.)
Presentation
Publication
Other

AICCMQ Professional Development Grants 2013-4
Go to 2.3

2.3 Budget Information
Please list costs needed to complete the grant proposal. Include any expenses in addition to those for which you
are applying. Note AICCM Q PDG funding is not eligible for meals and incidentals, thus this line is not included
below.
Item
Description and
Calculations
Additional
funds
amount
Total
estimated
costs
Registration
$:
$:
Transportation
$:
$:
Accommodation
$:
$:
Other (please
describe)
$:
$:
Total Proposal
Expenses
$:
$:
Source of funds
(e.g. AICCM Q PDG, Self,
Institution, other funding)

Go to 2.4
2.4 Other financial assistance
Please indicate other financial support you have applied, or intend to apply for, to undertake your proposal. If
you have already been notified of your successful grant, please include the amount you received. If further
notification of funding from other areas is received after your submission to AICCM (Qld) Inc, please notify us as
soon as possible. The level of other assistance available will be a consideration in assessing applications and
any conditions will be detailed in a Funding Agreement to be signed by the successful applicant.
Funding
body/agency
Funding
program
Phone no.
Date applied
Date notified
DD/MM/YYYY
DD/MM/YYYY
$:
DD/MM/YYYY
DD/MM/YYYY
$:

AICCMQ Professional Development Grants 2013-4
Amount
requested
Go to 3.0
3. SUPPORT MATERIAL
The following support material is recommended.
A CV no longer than two A4 pages
Written confirmation of relevant activities (e.g. registration details, letters of acceptance)
Itinerary of tour or travel arrangements (if applicable)
Conference/workshop program (if applicable)
Please note

For audit purposes, AICCM is required to retain all support material supplied by applicants.

Go to 4.0
4. CERTIFICATION
All applicants
I, the undersigned, certify that:


The statements in this application are true and correct to the best of my knowledge, information and belief,
and the supporting material is my own work.
If this application is approved, I consent to the media being given information about the funded proposal.
Signature:

Date:
DD/MM/2013
Name in full:

Go to 5.0
5. APPLICATION PREPARATION
BEFORE YOU SEND IN YOUR APPLICATION MAKE SURE
You have answered all the questions on the application form.
You have checked that your proposal’s starting date falls more than 5 weeks, but less than one year
after the submission date.
You have signed the application form
You meet the eligibility criteria specified on the front page and you are submitting the application
form, cv, confirmation of activity, itinerary, conference program (if relevant).
You have kept a copy of your application for your own records.
PLEASE SUBMIT YOUR APPLICATION INCLUDING SUPPORT MATERIAL ELECTRONICALLY TO
Gajendra.Rawat@slq.qld.gov.au
If you require further information or assistance contact Gajendra.Rawat@slq.qld.gov.au
AICCMQ Professional Development Grants 2013-4