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Individual Capacity Building (ICB) Program Grant Opportunity 2019-2020
This form has been submitted for consideration for the above Application process. Based on system generated information it appears that this Application has been submitted on time. Contact via Phone on or via email for any questions regarding this Application.
This form has been submitted for consideration for the above Application process. Based on system generated information it appears that this Application has not been submitted on time. The Application is therefore unlikely to be accepted. Contact via Phone on or via email for any questions regarding this Application.

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Individual Capacity Building (ICB) Program Grant Opportunity 2019-2020
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Application Information

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longDescription

Community Grants Hub

This grant round is being administered by the Community Grants Hub, on behalf of the .

Closing Date/Time

Applications must be submitted by .
Closing Time: System generated information indicates that this Application process has closed. Contact via phone on or via email for any questions regarding this Application process.
Closing Time: System generated information indicates that this Application process has closed. Please check the latest details on the GrantConnect website to ensure the Application process is still open prior to trying to submit the form. Note that while your form may still be able to be submitted, it may not be considered in the Application assessment process. Contact via phone on or via email for any questions regarding this Application process.
This application, if submitted, will be considered as a late application and as such the Community Grants Hub reserves the right not to consider this application. If you wish to continue this application through to the submission stage and believe you have exceptional circumstances then you must provide details in the text box below as to why this application has been submitted after the published close date.Broadly, exceptional circumstances are events characterised by one or more of the following:

reasonably unforeseeable,beyond the applicant’s control,unable to be managed or resolved within the application period.
Exceptional circumstances will be considered on their merits and in accordance with probity principles.
(Limit: approx 300 words, 2,000 characters)

If you have any supporting document on your extenuating circumstances then you may attach here. Please note that this is not mandatory and is limited to one attachment only.

List of attachments
File:

Making Sure Your Application is Saved

The ‘Continue’ button will not save your Application. For your Application to be saved, you will need to click on: ‘Save and Exit’, and ‘Confirm’. You will know that your application is saved when you are taken from the current form process to the ‘Form Saved’ page. Note that the ‘Save and Exit’ button will ask that you ‘Confirm’ that you wish to save the Application, which you must do to complete the save process. If this is not done, your Application will not be saved. You can return to your Application with the data saved using the link on the 'Form Saved' page that says 'Click here to return to your form' and confirming your submission reference ID details.

Grant Opportunity Documents

Read all information in the Grant Opportunity Documents before completing this Application Form. The Grant Opportunity Documents are available on the GrantConnect website. Applications will be assessed using the process outlined in the Guidelines.
Read all information in the Grant Opportunity Documents before completing this Application Form. The Grant Opportunity Documents are available on the GrantConnect and Community Grants Hub websites. Applications will be assessed using the process outlined in the Guidelines.

Application Help

Information about the Application process is available on the GrantConnect website. Applicants must submit any questions relating to the Program or this Application process in writing to . Applicants may submit these questions up until five Business Days prior to the Closing Time and Date. A response will be provided within five business days. Applicants may direct any general enquiries, requests for technical help or support in using and/or submitting the Application Form by: Phone Email to
Information about the Application process is available on the GrantConnect and Community Grants Hub websites. Applicants must submit any questions relating to the Program or this Application process in writing to . Applicants may submit these questions up until five Business Days prior to the Closing Time and Date. A response will be provided within five business days. Applicants may direct any general enquiries, requests for technical help or support in using and/or submitting the Application Form by: Phone Email to

Attachment Limits

This Application Form allows users to attach files to support their application, use the ‘Click to Upload’ button to select your file only. Do not drag and drop or use any method other than the ‘Click to Upload’ button provided to attach files. The maximum size for individual attachments is no larger than 2MB and the form will not accept individual attachments above this size. Please plan to modify your attachment files accordingly if necessary. Accepted file types:
.bmp, .doc and .docx, .gif, .jpeg, .Jpg, .msg, .pdf, .png, .pps, .ppt, .pptx, .txt, .xls, .xlsb, .xlsx.
Note: Compressed files, such as .zip, .rar, are not accepted and foreign characters should not be used in file names.

Sharing this Form

More than one person should not access this form at the same time. If this is done there is a risk that information entered in the form may be lost and not transferred upon submission. If you wish to share this form and access details, please ensure that only one user edits the form at any given time. To avoid any issues with your submission, ensure each contributor has completed their updates, saved their changes and exited the form prior to another person accessing the same form.

Submission Reference ID

Each Application Form is allocated a unique Submission Reference ID. Each time this Application is accessed you will be required to use this Submission Reference ID.

Submitting Application Form

Once you have completed this Application Form, you must submit it electronically by using the submission section at the end of this form. Please note: there may be short, scheduled outages to systems as part of regular information technology maintenance that may affect submission of this form. Notification of these outages will be on the website. Following electronic submission, a message with your Submission Reference ID will appear on your screen. An email will be sent to the main email contact provided in the Application Form. A function is also available on the submission page to allow you to send a receipt email to the address of your choosing. Please save this email receipt for future reference and use it in all correspondence about this Application. Note: Applications will be assessed using the process outlined in the Grant Opportunity Documents. Applicants will be notified of the grant funding outcome on completion of the assessment process.

National Relay Service (NRS)

The Community Grants Hub uses the NRS to ensure our contact numbers are accessible to people who are deaf or have a hearing or speech impairment. Please phone to access the NRS.

Privacy

The Community Grants Hub uses an integrated Smartform service assisted by the Department of Industry, Innovation and Science on www.business.gov.au. If you are providing information to access a non-Department of Industry, Innovation and Science program, that information will not be accessed by Department of Industry, Innovation and Science employees. The only exception to this is where Senior Analysts within the Department of Industry, Innovation and Science require access to your information for the sole purpose of troubleshooting technical errors. Where this occurs Senior Analysts will only access the data with permission and at the request of client agencies. The Community Grants Hub will be able to access the Application as part of the form support services. For more information about how the Department of Industry, Innovation and Science protects your privacy and personal information, please see the Department of Industry, Innovation and Science’s Privacy Policy. The Community Grants Hub Privacy Policy and WCaG Accessibility Information and the Privacy Policy should also be read and understood.

Use of Information

Fields marked with * are required
Your Submission Reference is:


Please send yourself a link to this saved form by entering your email address below. This email will detail your Submission Reference, the date and time this application process will close, and a link to access your saved form. If you have any questions relating to this Application phone or email .

Use of Information

The Community Grants Hub may use the information, other than personal information, provided in this Application Form to assist it to:

comply with the Australian Government requirement to publish the details of all grant recipients on the GrantConnect website, inform staff negotiating and establishing Grant Agreements of risks and issues that need to be addressed in the Grant Agreement for that program, and/or inform future assessments for Applications.
You can only apply if you agree to the Community Grants Hub using the information (not personal information) you provide in this form for the purposes listed above.
Check this box if you agree to the Community Grants Hub using the information (not personal information) you provide in this Application Form.

Existing Grant Recipient

Fields marked with * are required

Is the Applicant an existing Grant Recipient? *

You must respond to this question. Select 'No' if the Applicant is not an existing recipient of a grant through the Community Grants Hub. Select 'Yes' if the Applicant is an existing recipient of a grant through the Community Grants Hub. If yes is selected you then must enter your organisation ID number in the next field. The Applicant’s organisation ID number should be entered as it appears on the Grant Agreement. After entering the organisation ID, click on the 'Search' button to validate the ID to bring back key organisation details for this Application. Should there be any issues with validation, a message will be returned to give a choice on actions to progress. If you require assistance, please call .
If Yes, provide the Organisation Id number as it appears on your Grant Agreement and then click 'Verify number' to confirm the details are correct Tip: Copy and paste the Organisation Id number from the Grant Agreement to avoid errors.

Are updates required to the Applicant's details? *

You must respond to this question. Select ‘No’ if updates are not required to the Applicant’s details as currently held by the Community Grants Hub. Select ‘Yes’ if updates are required to the Applicant’s details as currently held by the Community Grants Hub. You will be required to contact your Funding Arrangement Manager to update your details.

Updates to Applicant Details

Fields marked with * are required

Please contact your Funding Arrangement Manager to update your details.

Mandatory check box if the response was 'Yes' to the question: "Are updates required to the Applicant’s details?" Check this box to confirm that you have contacted your Funding Arrangement Manager and your organisation information is now current.

Applicant Details

Fields marked with * are required

Does the applicant have an Australian Business Number (ABN), Australian Company Number (ACN) or Australian Registered Body Number (ARBN)? *

You must respond to this question. For further details refer to http://www.abr.business.gov.au/.
If Yes, provide the Applicant's ABN and ABN Branch Number (if applicable)
Enter your ABN into the Australian Business Number (ABN) field and click the Validate ABN button to retrieve your registration details.
Enter the ABN Branch Number relevant to the Applicant’s ABN, if applicable. This is limited to 3 digits.
Enter your ACN into the Australian Company Number (ACN) field and click the Validate ACN button to retrieve your registration details.
If you have Trading/Business Names registered, you can select the relevant Business Name. If you have not registered your Business Name, you can either select "Same as Legal Entity" or "Other" in the "trading name/business name" field. If "Other" is selected, you will be asked to provide the Applicant's trading/business name in another field that will become available.
If No, attach a completed Statement by a supplier (reason for not quoting an ABN to an enterprise). Further information about a Statement by a Supplier is available on the ATO website.

Attachment *

List of attachments (Note: Attach any relevant documentation. Mandatory to provide at least one document where it has been indicated that the Applicant is able to provide a completed Statement by a supplier. Only .doc .docx .pdf will be accepted)
File:

What is the Applicant's Legal Name? *

If your Application is successful, will only enter into a Grant Agreement with this legal entity. It may be different to the name the Applicant trades or provides services under.
You must respond to this question. 80 character limit. NOTE: This field accepts the characters of A to Z, 0 to 9, ( ) . , ’ & -/ \ @, all other characters including carriage returns are not accepted.

Does the Applicant have a trading name (business name) different to their legal name? *

This is the trading/business name that the Applicant trades or provides services under. For further details about having a trading/business name refer to http://www.asic.gov.au. An example of an Applicant trading under a business name would be ABC Pty Ltd trading as Alpha Bravo Charlie Services.
You must respond to this question. Select 'No' if the Applicant does not have a trading name different to their legal name. Select 'Yes' if the Applicant trades under a name (eg. Business name), different to their legal name. If 'Yes' is selected, you must then enter the business/trading name in the 80 character limit field provided. NOTE: This field accepts the characters of A to Z, 0 to 9, ( ) . , ’ & -/ \ @, all other characters including carriage returns are not accepted.

What is the registered business address and main contact details of the Applicant?

The business address must be completed in full and not be a PO Box. For example: Level 1 Main Building 220 Business Street Canberra City ACT 2601 Note: the address fields accept the characters of A to Z, 0 to 9, ( ) . , ' & - / \ @, all other characters including carriage returns are not accepted. Please note that if an Applicant selects 'Unable to validate' following an initial failed validation attempt, the Department will use this non-validated address for correspondence.
Address Validated
Address NOT Validated

What is the postal address of the Applicant?

The postal address must be completed in full. For example: Level 1 Main Building 220 Business Street Canberra City ACT 2601 Note: the address fields accept the characters of A to Z, 0 to 9, ( ) . , ' & - / \ @, all other characters including carriage returns are not accepted.

What is the Applicant's financial email address for the receipt of payment advice should the Application be successful?

You must respond to this question. 350 character limit. The email address must be entered in a valid format without spaces (eg. example@business.com.au). Payment advice includes Recipient Created tax invoices (RCTIs).

Is the Applicant GST registered? *

To be registered for GST the Applicant must have an active ABN. Questions on GST requirements should be addressed to the Australian Taxation Office. See www.business.gov.au for more information.

Does the Applicant operate as not-for-profit? *

For eligibility requirements, refer to the Guidelines. For further details about not-for-profit organisations refer to the Australian Tax Office website.
You must respond to this question. Select ‘No’ if the Applicant operates for profit. Select ‘Yes’ if the Applicant operates as not-for-profit.

Is the Applicant registered as a charity by the Australian Charities and Not-for-profits Commission (ACNC)? *

For further details refer to http://www.acnc.gov.au/.
You must respond to this question. Select 'No' if the Applicant is not registered as a charity by the Australian Charities and Not-for profits Commission (ACNC). Select 'Yes' if the Applicant is registered as a charity by the Australian Charities and Not-for profits Commission (ACNC).

Eligibility Requirements

Fields marked with * are required

What is the Applicant's legal entity type? *

For a list of eligible legal entity types, refer to the Guidelines. If you are unsure about the Applicant's legal entity type, please seek professional advice (e.g. from your lawyer or accountant) or refer to the Australian Business Register website for further information.
You must respond to this question. Choose the legal entity type that is relevant to the Applicant from the list. NOTE: Use the field’s scroll-bar or the keyboard’s down-arrow to view all available options. If you are unsure about the Applicant's legal entity type, please seek independent advice (e.g. from your Accountant) or refer to http://www.abr.business.gov.au/ for further information.

Is the Applicant able to provide documentation to support the legal entity type? *

You must respond to this question. At least one attachment must be provided if the response to "Is the Applicant able to provide documentation to support the legal entity type?" was 'Yes'. Select 'No' if the Applicant is not able to provide documentation to support the legal entity type. Select 'Yes' if the Applicant is able to provide documentation to support the legal entity type. If 'Yes' is selected, click the 'Click to Upload' button to add the file in each attachment section and then click the 'Add Attachment' button to add sections for subsequent attachments. Note: the maximum size permitted per attachment file is 2mb and the overall form has the capacity to take 15MB of attachments in total. Once a file has been uploaded or an attachment section has been added, select the appropriate 'X' symbol button to delete. NOTE: There is a maximum of 2 attachments for this question if the response is Yes.
As the Applicant has indicated that the Legal Entity type is Trustee on behalf of a Trust in order to validate your organisation as a Legal Entity you are required to provide a copy of your full and signed Trust Deed identifying both the trust and trustee. Click the 'Click to Upload' button to add the file in each attachment section and then click the 'Add Attachment' button to add sections for subsequent attachments. Note: the maximum size permitted per attachment file is 2mb and the overall form has the capacity to take 15MB of attachments in total. Once a file has been uploaded or an attachment section has been added, select the appropriate 'X' symbol button to delete. NOTE: There is a maximum of 2 attachments for this question if the response is Yes.
As the Applicant has indicated that the Legal Entity type is Organisation established through a specific piece of commonwealth or State/Territory legislation in order to validate your organisation as a Legal Entity you are required to provide one of the following: your Government Gazette a copy of your Certificate of Incorporation or Letter of Patent the name and section of the Act that incorporates your organisation Click the 'Click to Upload' button to add the file in each attachment section and then click the 'Add Attachment' button to add sections for subsequent attachments. Note: the maximum size permitted per attachment file is 2mb and the overall form has the capacity to take 15MB of attachments in total. Once a file has been uploaded or an attachment section has been added, select the appropriate 'X' symbol button to delete. NOTE: There is a maximum of 2 attachments for this question if the response is Yes.
In order to validate your organisation as a Legal Entity you are required to provide a copy of your full and signed Trust Deed. Note: It is mandatory to provide one document where it has been indicated that the Legal Entity is a Trustee on behalf of a Trust.
List of attachments (Note: Attach any relevant documentation. Mandatory to provide at least one document where it has been indicated that the Applicant is able to provide documentation to support their legal entity type.)

Attachment *

List of attachments (Note: Attach any relevant documentation. Mandatory to provide at least one document where it has been indicated that the Applicant is able to provide documentation to support their legal entity type. Only .doc .docx .pdf will be accepted)
File:

Header Text

Question Detail
(Limit: approx characters)

Under what Organisation type is this application being made? *

Applicants must meet the organisation criteria of a DPO/FO or PCL organisation to be eligible to apply for this grant round. Further information regarding the criteria for these organisation types is provided in the Grant Opportunity Guidelines.Description of organisation types:Disabled Peoples Organisations and Family Organisations (DPO/FOs) with paid staff and a Board, who meet both of the eligibility criteria outlined below:Actively evidence and demonstrate their commitment to the Social Model of Disability, which seeks to remove barriers for people with disability to access mainstream services and live an ordinary life; andAre run by and for people with disability and/or their families which is supported by evidence of a minimum of 50% of people with a disability and/or their families making up the organisation’s board or staff (or both).Disabled Peoples Organisations and Family Organisations (DPO/FOs) with no paid staff, that meet both of the criteria outlined below: Actively demonstrate their commitment to the Social Model of Disability, which seeks to remove barriers for people with disability to access mainstream services and live an ordinary life; andAre run by and for people with disability and/or their families, which is supported by a minimum membership of 50% of people with a disability and/or their families making up the organisation’s volunteers.Priority Cohort Led Organisations (PCLs) - these organisations must have a minimum of 50% representation of the relevant cohort group on their board or staff and represent one or more of the following cohorts: Aboriginal and Torres Strait Islander communities; and/or organisations registered with the Office of the Registrar of Indigenous Corporations (ORIC); and/orCulturally and Linguistically Diverse (CALD) communities; and/orLesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning, Asexual and Plus Cohort.(LGBTIQA+).Note: Organisations who do not meet the definition of a DPO/FO or PCL cannot apply. By selecting the following organisation type, you (the applicant) are declaring that you meet the relevant organisation type criteria. The NDIA reserves the right to use information outside of this application form to determine if the applicant meets the criteria.
Select the relevant option.
As you are not a Disabled Peoples Organisations and Families Organisation (DPO/FO) or an ILC Priority Cohort Led (PCL) organisation you are not eligible to apply for the grant opportunity and will not be able to proceed.

What type of Disabled Peoples Organisations and Families Organisation (DPO/FO) is the organisation delivering the proposal? *

Note: If you are applying as an Auspice Organisation on behalf of an organisation, it is a requirement of this Grant Opportunity that the organisation you are Auspicing meets the definition of a DPO/FO or PCL group. In selecting your option you are confirming that your organisation meets the criteria and you can provide evidence to support this in the application form. The NDIA reserve the right to determine eligibility.

Which Funding Activity type are you applying for? *

The grant opportunity can fund activities that align with the following two activity types:Individual Capacity Building (ICB), which are activities that build the capacity of people with disability by ensuring that they have the knowledge, skills and confidence they need to set and achieve their goals. Proposed activities must be for the primary and direct benefit of people with disability, and developed and delivered in collaboration with people with disability.Organisational Capacity Building (OCB), which are activities that improve the ability of DPO/FOs to deliver their organisational mission and to deliver ILC in the community. Only applicants that meet the DPO/FO criteria can apply to deliver OCB activities. Further, DPO/FO applicants cannot apply to deliver only OCB activities. DPO/FO applicants must also apply to deliver ICB activities.
Select the relevant option.

Which ILC Priority Group your organisation is led by? *

These organisations must have a minimum of 50% representation of the cohort group on their board or staff and represent one or more of the following: Aboriginal and Torres Strait Islander communities; and/orCulturally and Linguistically Diverse (CALD) communities; and/orLesbian, Gay, Bisexual, Transgender, Intersex, Queer/Questioning, Asexual and Plus (LGBTIQA+) Cohort communities.
As you you have selected Aboriginal and Torres Strait Islander people you are required to attach your Cerificate of ORIC registration. *
List of attachments.
File:

Under what type of arrangement is this application being made? *

If you are an Auspice organisation applying on behalf of an organisation it is a requirement of this Grant Opportunity that you meet the definition off a DPO/FO as identified in the eligibility criteria in the Grant Opportunity Guidelines.
Select the relevant option.

Auspicing arrangement

Some organisations or groups cannot apply directly for this ILC funding round – they require an Auspicor (as per the Grant Opportunity Guidelines). The Auspicor applies on behalf of this organisation/group (the Auspicee). The Auspicee will still carry out the project, but under the guidance of the Auspicor. The Auspicor can be any organisation that is a legal entity and capable of satisfying the additional requirements outlined in Grant Opportunity Guidelines.The Auspicor becomes the applicant and, if the application is successful, the Auspicor will receive and manage the funding on behalf of the Auspicee. If successful, the Auspicor is the contracting entity and is legally responsible for meeting the contractual obligations of the grant.
Please attach a letter of declaration confirming the Auspicing arrangement. Declaration to be completed by the Auspicee on the template provided in the Grant Opportunity Documents (and are available on GrantConnect and Community Grants Hub websites). *
List of attachments.
File:
Provide the name of the organisation that your organisation is auspicing, and details of a contact person from the auspicee organisation. Note: The fields accept characters of A to Z, 0 to 9, (),.'&-/\@, all other characters and formatting are not accepted.

Auspicee Organisation contact person details

Consortium

An Applicant may determine that service delivery is best achieved through the use of a consortium arrangement. You will be required to provide the details of each consortium member details. Up to 20 consortium members can be included in the Application Form by clicking the add button at the end of this question.

Details

You have reached the maximum number of records allowed.
Do you have more than 20 consortium members?
More than 20 consortium members.If you have more than 20 consortium members, please supply the same details as asked for the first 20 in a document and attach to this Application. This is mandatory if you have indicated that you will have more than 20 consortium members.
More than 10 consortium members
File:
If the Application is successful, the Applicant will be offered a Grant Agreement as the lead agency and held liable for all obligations contained in the Grant Agreement's Terms and Conditions. This includes monitoring, management, financial performance, service outcomes and insurance coverage.

The panel of consortium members does not enter into a Grant Agreement. The Applicant should obtain agreement prior to submitting this Application.

Further evidence of the consortium arrangements may be sought from successful Applicants prior to the signing of the Grant Agreement.

Service Delivery

(Limit: approx 300 words, 2,000 characters)

Registered Provider of Support

Is the organisation a registered provider of support with the NDIA? *(For an auspice application, this question needs to be answered as per the auspicee (the organisation being auspiced))A provider is an individual or organisation delivering a support or a product to a participant of the National Disability Insurance Scheme (NDIS). Organisations or individuals can apply to be a registered provider with the National Disability Insurance Agency (NDIA).Whilst registered providers of support can apply for a grant under this ILC grant opportunity, it is not an eligibility requirement for the purposes of this grant round. These types of organisations intending to apply for funding under this grant opportunity should refer to the Service Provider and Conflict of Interest section of the Grant Opportunity Guidelines.

Has the organisation previously received ILC Funding? *

(For an auspice application, this question needs to be answered as per the auspicee (the organisation being auspiced))
(Limit: approx 150 words, 1,000 characters)

How much funding are you applying for? *

Select the relevant option.
Maximum funding that can be applied for per application:Disabled Peoples Organisations and Families Organisations (DPO/FO)Individual Capacity Building activites: $600,000 per year (maximum of $1,800,000 over 3 years)Organisational Capacity Building activites: $50, 000 per year (maximum of $150,000 over 3 years)
Priority Cohort Led Organisations (PCL)Individual Capacity Building activies: $600, 000 per year (maximum of $1,800,000 over 3 years)

Governance

Fields marked with * are required
Do any of the following legal situations apply to the Applicant?

Has the Applicant been involved in any litigation or prosecution in the past three years? *

You must respond to this question. Select 'No' if the Applicant has not been involved in any litigation or prosecution in the past three years. Select 'Yes' if the Applicant has been involved in any litigation or prosecution in the last three years. If 'Yes' is selected, you must then provide details and/or explanation of why the litigation or prosecution should not be considered relevant to the Application in the 2000 character limit (approximately 300 words) field provided. The character count includes letters, numbers, spaces, paragraph marks, bullet points etc. If the Applicant has settled a claim on confidential terms, please indicate this in your response. The Community Grants Hub may request further information as part of the assessment process. NOTE: In this field, please only enter the characters of A to Z, 0 to 9, ( ) . , ’ & -/ \ @. Other characters should not be entered as there is a risk of data corruption.
(Limit: approx 300 words, 2,000 characters)

Has any senior official or person directly involved in delivering the Activity (should the Application be successful) been involved in any litigation or prosecution that may reasonably be considered to be relevant to the Application? *

You must respond to this question. Select 'No' if no senior official or person directly involved in delivering the Activity (should the Application be successful) has been involved in any litigation or prosecution that may reasonably be considered to be relevant to the Application. Select 'Yes' if any senior official or person directly involved in delivering the Activity (should the Application be successful) has been involved in any litigation or prosecution that may reasonably be considered to be relevant to the Application. If 'Yes' is selected, you must then provide the details of any senior official or person directly involved in delivering the Activity and details of the litigation or prosecution in the 2000 character limit (approximately 300 words) field provided. The character count includes letters, numbers, spaces, paragraph marks, bullet points etc. If the Applicant has settled a claim on confidential terms, please indicate this in your response. The Community Grants Hub may request further information as part of the assessment process. NOTE: In this field, please only enter the characters of A to Z, 0 to 9, ( ) . , ’ & -/ \ @. Other characters should not be entered as there is a risk of data corruption.
(Limit: approx 300 words, 2,000 characters)

Has there been any significant financial matter which may impact on the Applicant in the performance of the Activity? *

You must respond to this question. Select 'No' if there has not been any significant financial matter which may impact on the Applicant in the performance of the Activity. Select 'Yes' if there has been any significant financial matter which may impact on the Applicant in the performance of the Activity.
Note: you may be required to provide documentation upon request.

Are there any future commitments or contingent liabilities that might materially affect the Applicant in the performance of the Activity? *

You must respond to this question. Select 'No' if there are not any future commitments or contingent liabilities that might materially affect the Applicant in the performance of the Activity. Select 'Yes' if there are any future commitments or contingent liabilities that might materially affect the Applicant in the performance of the Activity.
Note: you may be required to provide documentation upon request.

Is the Applicant able to provide the following financial information?

A 'Yes' or 'No' response to all sub questions on whether the Applicant is able to provide the following financial information is Mandatory. Two most recent sets of year-end audited financial statements. Current year-to-date financial information, for example, income and expenditure statement and balance sheet. The Applicant's financial statements fully compliant with the Australian Accounting Standards. If 'No' is selected for any of these sub questions, you must then provide a brief explanation for the 'No' response in the 2000 character limit (approximately 300 words) field provided. The character count includes letters, numbers, spaces, paragraph marks, bullet points etc. NOTE: In this field, please only enter the characters of A to Z, 0 to 9, ( ) . , ’ & -/ \ @. Other characters should not be entered as there is a risk of data corruption.
Note: you may be required to provide documentation upon request.
1. Two most recent sets of year-end financial statements.
2. Current year-to-date financial information, for example, income and expenditure statement and balance sheet.
3. Are the Applicant's financial statements fully compliant with the Australian Accounting Standards?
(Limit: approx 300 words, 2,000 characters)

Does the Applicant have the following documents?

Note: you may be required to provide documentation upon request.
A 'Yes' or 'No' response to all sub questions on whether the Applicant is able to provide the following documents is Mandatory. Documented organisational and financial policies and procedures. Business plan and/or strategic plan. Risk management plan. Note: You may be required to provide copies of the above documentation within 7 days upon request.
1. Documented organisational & financial policies & procedures.
2. Business plan and/or strategic plan.
3. Risk management plan.
4. Annual Report
5. Public Liability Insurance
Confirm the applicant has, or is willing to obtain prior to execution of the grant agreement, Public Liability Insurance coverage for the duration of the project. *

Header Text

Question Detail
(Limit: approx characters)

Organisation Details

Fields marked with * are required
(For an auspice application, the following organisation detail questions need to be answered as per the auspicee (the organisation being auspiced))

Organisation Details - Board

How many of your Board members identify as:

If not applicable enter ‘0’.

Organisation Details - FTE staff

How many full time equivalent (FTE) staff identify as:

If not applicable enter ‘0’.

Organisation Details - Volunteers

Organisation Details – Board members with disability

Organisation Details – Board members who are family or carers of people with disability

Organisation Details – FTE staff with disability

Organisation Details – FTE staff who are family or carers of people with disability

Organisation Details - Volunteers with disability

Organisation Details – Volunteers who are family or carers of people with disability

Additional Information

Fields marked with * are required

Type of Individual Capacity Building Activities

Select the type of individual capacity building activities that is proposed to be delivered. *
Types of individual capacity building activities that this grant round will fund includes:peer support groupsmentoring programsskill building programs for self-management and independencecapacity building programs to enable people to speak up for themselvesother programs or activities to develop the capacity of individuals with disability: which could involve the establishment or piloting new or innovative supports or services led by people with disability for people with disability.For definitions of individual capacity building activity types please refer to the Grant Opportunity Guidelines.
(Limit: approx 10 words, 70 characters)

Type of Organisational Capacity Building Activities

Select the type of organisational capacity building activities that is proposed to be delivered. *
Fundraising or marketing excludes the marketing of any supports if the DPO/FO is also registered as a Provider of NDIS Support.Program development excludes the costs associated with registration as a Provider of NDIS Support and its associated quality assurance activities.Applicants may apply for no more than three OCB activities.
Types of organisational capacity building activities that this grant round will fund includes:

Describe the specific activities that you intend to do to build organisational capacity and why these are important. *

(Limit: approx 525 words, 3500 characters)

Primary Disability Groups

Select the primary disability group this application relates to.

Details of Other Primary Disability Groups