Sustainable Farming in the South West 2013-2018 Application Form – Round 1 Closing Date for applications is 20th November 2013 (Please refer to the ‘Sustainable Farming in the South West Funding Guidelines – Round 1’ for further information about the project and to use as a guide for completing this application form) 1 APPLICATION FORM – ROUND 1 Closing date for Round One applications is 5pm Wednesday, 20th November 2013 Organisation/Business Name: Legal Entity Name (if different to above): Title: Miss Ms Mrs Primary Contact Name: Email: Mobile Number: Fax: Mr Other: Phone Number: Organisation status: Incorporated body Statutory body Corporate body Sole Trader Partnership Contractor Individual Other please specify: Preferred contact method: Phone Mobile Email No preference ABN: GST registered? Yes No Do you have current workers compensation insurance? Yes No Do you have current public liability insurance? Yes No Physical Address: Physical Address City/Town: State: Postcode: Mailing Address (if different to above): Mailing Address City/Town: State: Postcode: Organisation/Company Website (if applicable): 1. Project Title: 2. Which funding priorities is your project addressing? Please tick all that apply Maintaining groundcover levels above regional groundcover targets to reduce soil and nutrient loss, through wind and water erosion, and improve air and water quality Managing soil acidification to improve productivity and avoid future loss of productive land through subsoil acidification Managing nutrient addition to soils to improve productivity, reduce losses into waterways and slow 2 rates of soil acidification Improving soil health through better soil biology, better nutrient matching and management of soil structure where it can be demonstrated that this will lead to increased productivity, provision of ecosystem services and reduced nutrient loss 3. Please give a brief outline/overview of your Sustainable Farming project in 100 words or less: 4. What are the projects’ main aims and objectives, and how do these address the funding priorities identified above? 5. What are the planned on-ground activities required to set up the demonstration or trial? Please include an approximate timeline for undertaking these activities (note all projects MUST be completed by the 31st December 2017). 6. What are the planned monitoring methods for the demonstration or trial? Please indicate type, timing and frequency of monitoring. 7. How many farming businesses will be directly involved in the demonstration or trial? 8. How you will extend and share knowledge within your local farming community? Outline the type and number of extension activities related to this project (e.g. workshops, field days, paddock walks, case studies, you-tube videos, media articles and signage). 9. Why are the outcomes of this project important to your local farming community? 3 10. Please indicate where the participating farmer/s sit on the adoption cycle (Nicholson et al. 2003) for the management practice you want to trial or demonstrate? Provide a brief explanation where necessary. 11. Please provide a broad indication of the budget for your project. A list of budget items will be needed to assess this application; however a detailed cost breakdown will be finalised at a later stage if your project is successful. Please remember: All figures in the below budget should be quoted excluding GST. The maximum amount of funding that can be applied for is $40,000 ex. GST. Funding recipients are expected to make a significant contribution to the costs of the project via inkind and/or financial contribution, depending on the level of private benefit that may be derived from the project activities. As a general rule, the contribution should be equal to the funding requested. A maximum of 10% of project funds can be allocated to MERI activities, including GIS mapping, photo monitoring, farmer surveys, and reporting to SWCC as required. This does not include the cost of detailed trial site monitoring & data collection (i.e. soil sampling) or data analysis. A maximum of 10% of project funds can be allocated to administration costs, for example project development & coordination, stakeholder liaison, phone & internet, photocopying. This does not include the cost of delivering extension activities. To calculate the maximum funding amount allowable for administration and MERI, total all other SWCC funding requested for project activities (i.e. on-ground and extension), then calculate 20% of this figure. Where an application is submitted by an individual or group which does not have the capacity to coordinate and report on that project successfully, a SWCC staff member or locally based Project Support Officer (PSO) will be nominated. PSO’s will be responsible for assisting in project development and coordination, MERI, reporting, record keeping and general communications. In such instances the funding for administration & MERI will be separate to the project funding, and should not be included in the budget below. Please contact SWCC if you have any questions regarding the above points. 4 BUDGET: SWCC funding requested Planned Activity In-kind contribution Approximate completion date of planned activity On-ground work Monitoring & evaluation of the project site (i.e. soil & water sampling) Extension, capacity building and community engagement Project administration and MERI costs (maximum 20%) TOTAL $ $ Estimated Project Completion Date: 12. Site map: Please attach a project site map that shows the location of proposed on- ground works. 5 13. Have you received assistance to develop this application? If so, by Whom? 14. Do you have any other comments not covered by this application form that you would like us to consider in assessing your application? I hereby confirm that the information provided in this application form is true and correct to the best of my knowledge and that I have the authority to submit this form as a representative of the applicant organisation. SIGNATURE OF APPLICANT: DATE: Please submit all applications to SWCC by 5pm 20th November 2013: Email: swcc@agric.wa.gov.au Post: The South West Catchments Council, P.O. Box 5066 Bunbury DC, W.A. 6230 Fax: (08)9780 6198 Thank you for your application. We will send an email confirming our receipt of your application, and all Round One applications will be notified in writing of the outcome of their application by Friday 6th December 2013. 6