THE THE SSI-NSA INNOVATION GRANT PROPOSAL FORM – FY2015 SSI-NSA Innovation Grant (SSI-NSA IG) and the Objectives To give the National Sports Associations (‘NSAs’) more certainty and a funding booster, THE SSI-NSA IG is a grant scheme to support innovative ideas and the developmental plans. Projects that may qualify for THE SSI-NSA IG scheme funding, demonstrate the potential of the following broad elements: Catalyst to value-add and inject new energy to take the sport to the next level; Be the new growth engine for sport through innovation; Be a game-changer that revolutionise and transform the sport or NSA; Have desired incremental, long-term effect on the national sport delivery and eco-system. Application Procedures (1) Meet with your Sport Development Manager (‘SDM’) or Sport Singapore’s officer to discuss the feasibility of your plan and to understand the channels of support, including if THE SSI-NSA IG scheme amongst other Sport Singapore’s grant schemes, is appropriate. (2) Complete all sections in THE SSI-NSA IG Proposal Form (‘the Form’). If the space provided is insufficient, a separate sheet may be used. Where information is not yet available or the field is not applicable, please do not leave blank and indicate accordingly. (3) Ensure that the below documents are properly labelled as Annex and accompanied in the submission of THE SSI-NSA IG Proposal Form: Accompanied Documents Annex A Annex B Annex C Annex D The latest statutory accounts and the auditor’s report of the NSA. The organisation chart of the NSA’s management committee. A separate sheet on the full project timelines – milestone dates, procurement process, certification of project (where required) etc. A separate sheet on the full budget breakdown of the project. Attach at least two quotations from identified suppliers if procurement of goods/services is applicable. Required Yes (all submissions) Yes (all submissions) Optional if the project timelines has been detailed in FULL under Part Two of the Form. Optional if the budget breakdown has been detailed in FULL under Part Six of the Form. (4) Submit THE SSI-NSA IG Proposal Form and above accompanied documents to your dedicated SDM or Sport Singapore’s officer. THE SSI-NSA IG Proposal Form should reach Sport Singapore (Attention: Business Planning Department, Singapore Sports Institute), by hand, before the close of FY2015 grant call application on 15 May 2015, Friday. THE SSI-NSA IG FY 2015 | Property of Sport Singapore | No part of the Form is to be altered Page 1 of 5 PART ONE INFORMATION ORGANISATION Name of the NSA or Organisation Type of the NSA or Organisation (tick one only) NSA OF THE NATIONAL Charity status Commercial Entity* Yes SPORT ASSOCIATION (NSA) OR No *Please submit an organisation profile, including registration information and testimonials as supporting documents. UEN/ACRA No : Others* : Name of Organisation Address Postal Code Salutation Country Contact Person Name Designation Mobile Tel/DID Fax Email Website PART TWO DETAILS OF THE PROJECT Description of the Project Executive Summary of the Project Start Date (or Effective Date) dd/mm/yyyy Project timeline (Please indicate below or elaborate in a separate sheet and label it as Annex C) PART THREE End Date (or Expiry Date) dd/mm/yyyy Type of Sport SUMMARY OF JUSTIFICATIONS (Please describe the key considerations for applying THE SSI-NSA Innovation Grant) How does the project (or the project’s concept) support each of the below objective of THE SSI-NSA Innovation Grant? Catalyst to value-add and inject new energy to take the sport to the next level; Be the new growth engine for sport through innovation; Be a game-changer that revolutionise and transform the sport or NSA; Have desired incremental, long-term effect on the national sport delivery and eco-system. THE SSI-NSA IG FY 2015 | Property of Sport Singapore | No part of the Form is to be altered Page 2 of 5 PART FOUR WHAT SUCCESS WILL BE LIKE (Please summarize the key desired outcomes of the project) What success will look like at the end of the project? PART FIVE PROJECT PATHWAY AND IMPACT (Please describe your strategies in details) A. Social Impact How does the project promote the value of sport in a deliberate manner? B. Sporting Impact How does the project build a sporting culture with Singaporeans or Corporate Singapore? How does the project promote affinity of Team Singapore (TS) with the community? In organising this project, what are the short and long term benefits in capacity and capability development for the organiser, coaches, officials, local athletes and sport professionals? THE SSI-NSA IG FY 2015 | Property of Sport Singapore | No part of the Form is to be altered Page 3 of 5 C. Economic Impact What is the long-term vision and targets for future growth of the project? How can the project develop the local sports industry? e.g. Upgrade technical capabilities, sustained job creation, attract foreign investments and start-ups How does the project enhance the reputation of Singapore as a leading sports event city? How does the project demonstrate a unique value proposition for Singapore? PART SIX SUMMARY OF SUPPORT REQUEST FROM SPORT SINGAPORE (Please select the forms of support that you wish to enlist from Sport SG AND attach the breakdown for funding support, including quotations from identified suppliers) 1 Funding Support Total Amount (S$): Intended use of funds: (Please indicate below or elaborate in a separate sheet and label it as Annex D) 2 Facilities Support (Booking of Sport SG-owned venues not including Sports Hub) Description: 3 Any Other Forms of Support: (Please indicate below or elaborate in a separate sheet) Description: THE SSI-NSA IG FY 2015 | Property of Sport Singapore | No part of the Form is to be altered Page 4 of 5 PART SEVEN DECLARATION Has the company/association received, applied, or intend to apply for any financial support from other government agencies in Singapore? No Yes (please provide details below) Name of Scheme Name of Agency Name of Scheme Name of Agency Name of Scheme Name of Agency Name of Scheme Name of Agency Name of Scheme Name of Agency Has any legal proceedings been taken against the Company, including those which have commenced, concluded, or are ongoing? No Yes (please provide details of ongoing or concluded legal proceedings) On behalf of myself and the Organisation: i) ii) I declare that I am duly authorised by the Company to make this application on behalf of the Organisation. I declare that the information provided in this application is true and accurate to the best of my knowledge and I have not wilfully suppressed any material facts. I acknowledge and agree that any misrepresentation or omission in information will be grounds for the withdrawal of funding, if granted, and/or the recovery of any funds disbursed. iii) I undertake to inform Sport Singapore promptly in writing of any changes to the information provided in this application and any changes to circumstances that may affect this application. I further undertake to promptly provide the Sport Singapore with such information, documents and other materials as it may require from time to time in connection with this application. iv) I acknowledge that the submission of this application does not, of itself, automatically entitle the Organisation to funding. v) I hereby release the Sport Singapore, its directors, offices, agents or contractors from any and all liability whatsoever, to the full extent allowed by law, arising out of or in connection with any action, recommendation or advice or any of its services. vi) I consent to the release by one of the contents of this application by the Sport Singapore to third parties as appropriate, including without limitation sponsoring organisations or government agencies. Application completed by: Name Designation Tel/DID Mobile Email Name of the NSA/ Organisation Official Stamp of the NSA/ Organisation Signature Date THE SSI-NSA IG FY 2015 | Property of Sport Singapore | No part of the Form is to be altered Page 5 of 5