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Funding Application Form

Please read the funding guidelines on this site before submitting your application.

Name of Organisation who will be the main contract holder:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail address: (Required)

Purpose of Organisation (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years?

If Yes… please list name of funder, amount, year and purpose for which grant was given

Working Together More Fund – He Putea Mahi Tahi – Increasing Community Benefit by Working Together

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Additional Partner Organisation 1

Name of Partner Organisation:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail:

Purpose of Organisation: (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years? Y / N

If Yes… please list name of funder, amount, year and purpose for which grant was given

Partner Organisation 2

Name of Partner Organisation:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail:

Purpose of Organisation: (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years? Y / N

If Yes… please list name of funder, amount, year and purpose for which grant was given

Partner Organisation 3

Name of Partner Organisation:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail:

Purpose of Organisation: (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years? Y / N

If Yes… please list name of funder, amount, year and purpose for which grant was given

Partner Organisation 4

Name of Partner Organisation:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail:

Purpose of Organisation: (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years? Y / N

If Yes… please list name of funder, amount, year and purpose for which grant was given

Partner Organisation 5

Name of Partner Organisation:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail:

Purpose of Organisation: (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years? Y / N

If Yes… please list name of funder, amount, year and purpose for which grant was given

Partner Organisation 6

Name of Partner Organisation:

Charities Commission Number/Legal Status:

Postal Address:

Physical Address (if different):

Name of Contact:

Position in Organisation:

Telephone number:

E-mail:

Purpose of Organisation: (less than 70 words):

Have you received funding from any of the four funders or WTMF in the last two years? Y / N

If Yes… please list name of funder, amount, year and purpose for which grant was given

Working Together More Fund – He Putea Mahi Tahi – Increasing Community Benefit by Working Together

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What is the name of your collaborative initiative? (7 words):

Is this a new initiative? Y / N

What does your collaborative initiative involve? (less than 70 words):

What will this initiative achieve in terms of better outcomes for clients and/or strengthening of communities? (less than 70 words):

How will you know? (less than 70 words):

Estimated start date for this initiative:

Estimated completion date for this initiative:

Working Together More Fund – He Putea Mahi Tahi – Increasing Community Benefit by Working Together

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Budget: (please list full budget for this initiative)

Total estimated cost of project:

Total amount applied for:

As applicant, we…
allow the Funders to collect information about our organisation from other sources in order to assess this application agree that any grant will be used for the purposes specified or returned, unless the Funders
agree otherwise agree that if we receive a grant we will provide a brief report outlining how it has helped the people we work with and/or our organisation

Name of Authorised Member of Contract-Holder

Position in Organisation

Date

When you submit this form you will receive a copy of your application. Please sign that copy and send it to Working Together More Fund, P.O.Box 31250, Milford, Auckland 0620.

Please attach copies of
> most recent annual accounts of the organisation who will be contract-holder and main contact
> evidence of your legal status (if not registered with the Charities Commission)
> list of members of your Board/Committee

* Please Note: Applications must be received no later than 5pm on the close off date to be considered for the funding round

Application Submitted

A copy of your submitted application will be emailed to you.

About our funders

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Funding Application Form

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