The Ballarat Arts Foundation accepts submissions through this form below, or you can choose to download your application as a Word document and email your submission to grants(at)ballaratartsfoundation.org.au.

2017 BALLARAT ARTS FOUNDATION GRANT APPLICATION

SECTION 1: YOUR DETAILS
Tell us about yourself
Name *
Name
Postal Address *
Postal Address
Street Address (if different from postal)
Street Address (if different from postal)
Phone *
Phone
http://
Details of School Educational Achievement [VCE/VET; AMEB; etc.]
Are you currently completing any formal studies?
If yes, please provide details.
Please provide details.
SECTION 2: ARTS & COMMUNITY INVOLVEMENT
Please provide a statement [no more than 300 words] detailing your Ballarat community arts experience and involvement.
SECTION 3: ABOUT YOUR PROJECT
Outline the aims of your Activity/Project and describe how you would use the grant to contribute to and advance your emerging professional career. If your proposal involves travel please specify dates and places to be visited.
ACTIVITY START DATE
ACTIVITY START DATE
When does your planned project commence?
ACTIVITY END DATE
ACTIVITY END DATE
When does your planned project complete?
$
$
Please supply additional information about the costing, if deemed appropriate.
SECTION 4: ABOUT YOUR TEAM
KEY TEAM MEMBERS
KEY TEAM MEMBERS
Please add your key team members below, outlining their experience and role, if relevant. Please move on to the next section if you do not have any team members.
Key Team Member 2
Key Team Member 2
SECTION 5: YOUR BUDGET
Detail the costs associated with your proposed activity/project. Include such items as materials, fees, travel expenses individually. List each item on a separate line below. Attach separate budget report [if relevant]. Where the grant is to be used to purchase equipment or airfares a MINIMUM of two quotes MUST be submitted as part of your Grant Application. Please see the SUBMIT QUOTE BUTTON at the close of this form.
Please advise of the total cost of your project.
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$
$
$
$
SECTION 6: SUMMARY OF FUNDING SOURCES
Please tell us where you are additionally seeking and have secured funds.
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$
$
SECTION 7: references
If you are a student, at least one referee should be a current teacher/lecturer. Please note that referees will be contacted.
REFEREE 1
REFEREE 1
Address of referee 1
Address of referee 1
Phone of referee 1
Phone of referee 1
REFEREE 2
REFEREE 2
Address of referee 2
Address of referee 2
Phone of referee 2
Phone of referee 2
REFEREE 3
REFEREE 3
Address of referee 3
Address of referee 3
Phone of referee 3
Phone of referee 3
SECTION 8: FINAL NOTES AND ACCEPTANCE OF TERMS AND CONDITIONS
Signature *
You acknowledge and agree that by selecting the check box on this application form and submitting the form electronically will constitute signature by electronic communication under the Electronic Transactions (Victoria) Act 2000 and related Acts.
Date
Date

Please use this additional button to attach quotes to your application, or you would like to supply us with supporting documentation for your application (such as examples of your work or similar). Please clearly mark the supporting documentation with your name and contact details.