2010 Grant Application Form

16 April 2010
MLC Community Foundation
2010 Grant Application Form
Note: please complete this questionnaire with specific, short answers. Please submit this form as a
word document and attach to your email submission.
Please ensure that you keep to the numbering and order as below.
About the organization
1. Your organisation’s name & ABN:
2. A contact name, phone number & email address:
3. Your current corporate partners (if a financial institution, please advise the nature of the
relationship, including NAB):
4. The States in which you currently operate/deliver services:
5. What your organisation does in general i.e. mission, and specific to Mental Health and
6. Please confirm that you have read and understand the section on ‘Planning your
application’ shown on the invitation document and your organisation fits this criteria:
About your Program
1. Please provide a summary of the specific program/s or activities that this submission is
requesting funds for? (100 – 150 words)
2. Is this program current or proposed/new? Can you give an indication of program reach ie
number of community members benefited and number of volunteers?
3. Please illustrate how your organisation and programs align to our themes of; advice,
education and investing in the future.
4. Describe how your program impacts the community in relation to the Mental Health and
Wellbeing of Australian Families? What tangible, outcomes will the program deliver & how
do you measure these?
5. How much funding are you requesting? (up to a maximum of $50,000 per organisation)
6. Please detail the MLC staff volunteering opportunities that you can offer? What sort of
things could we do for you? (include skilled / general opportunities)
7. Are there any questions you have for us?
MLC Community Foundation 2010 Grants Program – Application Form
Anything else / supplementary (not mandatory)
You are welcome to submit any additional items you feel may be relevant.
This may include:
video/DVD/printed material of proposed program if available
media stories that you have generated relevant to your program
any research to validate the rationale for your program (if it is new/proposed)
your organisational profile or credentials document/PowerPoint/DVD
your annual report and accounts
If you have any questions please email [email protected] and we will
answer them as soon as we can.
Thank you
Thank you for taking the time to respond to our questions. We look forward to reviewing your
MLC Community Foundation 2010 Grants Program – Application Form