2019 H2 Northparkes Community Investment Program Application Form

Overview and eligibility

Thank you for applying for the Northparkes Community Investment program.

IMPORTANT: At the end of this form you will have the opportunity to upload supporting documentation such as quotes, flyers or supporting letters. If you have any questions about this application please call Ali Standen on 02 6861 3621 or email ali.standen@au.cmoc.com.

Northparkes Mines sponsors projects that create community benefit within the Parkes and Forbes Shires in the areas of:

• Economic Development
• Culture and recreation
• Education and Youth
• Environment
• Health

Northparkes assesses all applications according to:

• The availability of funds
• Value created for the community
• Value created for Northparkes
• Sustainability of the project

Please be aware that if your application is successful, up to ten weeks may pass before you are paid.

• It will take Northparkes one month after the due date to assess all applications
• Successful applicants will be required to sign their sponsorship letter and return it to Northparkes.
• Sponsorship will be paid to successful organisations within 30 days of Northparkes receiving their sponsorship letters.

Question Title

* 1. To make sure that Northparkes is the best source of funding for your community organisation, please answer the following questions.

If you answer no to all questions, your project is eligible to apply for funding from Northparkes. If you are not sure what to answer, ring Ali on 02 6861 3621 to talk more about your project.

Are you applying for money to:

	Yes	No
Benefit an individual?	Benefit an individual? Yes	Benefit an individual? No
Fund a religious or political activity, event or appeal?	Fund a religious or political activity, event or appeal? Yes	Fund a religious or political activity, event or appeal? No
Fund a recurring organisational expense?	Fund a recurring organisational expense? Yes	Fund a recurring organisational expense? No
Fund private business activities?	Fund private business activities? Yes	Fund private business activities? No
Fund an event where there will be gambling?	Fund an event where there will be gambling? Yes	Fund an event where there will be gambling? No
Pay off debt?	Pay off debt? Yes	Pay off debt? No