Community Growth Fund Acquittal Form

Details of Your Organisation

Select your organisation type:*This field is required.
Does your Organisation have an Australian Business Number (ABN)?*This field is required.
Is your Organisation registered for GST?*This field is required.
Does your Organisation have Public Liability Insurance?*This field is required.

Project Details

Please provide a summary of your funded project or event.

Include a brief overview of what took place, what worked well, and any challenges you faced. Share what you would do differently next time and highlight any positive outcomes or stories that could be shared with Council and the community.

This helps us understand the impact of your project and celebrate its success.

Please let us know if there were any changes to the original project or event outlined in your application.

If there were major changes such as using the funds for a different purpose (e.g. applying for an event and using the funds to pay rates). Please note that this would not be valid without prior approval from Council, as different terms and conditions apply depending on the type of request.

Minor changes (e.g. a date change or slight variation in delivery method) can be noted here for our records.

If you're unsure whether a change is considered major, please include it and we will review accordingly.

Which demographics that you indicate on your application attended?*This field is required.

Please provide the total number of attendees. Indicate whether this number is exact (e.g. based on registrations or ticket sales) or an estimate (e.g. headcount or visual estimate on the day).

In 200 words or less, describe any social or economic benefits your project created such as supporting local businesses, increasing participation, or strengthening community connection.

Please include how you measured or observed these outcomes (e.g. feedback, attendance numbers, partnerships, spending).

You can also list any local organisations or businesses that were supported as part of the project.

Please list all expenses related to the project or event, including:

  • Who the payment was made to (creditor)
  • What it was for
  • How much was spent

Note: The expenditure listed should align with the original budget submitted in your grant application. If there are any variations, please briefly explain them.

Example:
Creditor: Carnarvon Print Shop
Item: Posters and Flyers
Amount: $250.00

Marketing & Promotion

How was the Shire of Carnarvon acknowledge for sponsorship?*This field is required.
Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Application Checklist & Declaration

Please ensure all documents requested are attached to the application. Any application that is incomplete and does not have relevant documents attached will not be considered.

I, the undersigned, certify that:

  • The information provided above with respect to the expenditure of donation/contribution monies is true and accurate, and the funds have been applied in accordance with the purposes of the donation/contribution.
  • Any unexpended funds have been returned to the Council.
  • In providing the supplied content, including photographs, graphics, logos and/or any other content, you warrant that consent has been obtained and/or is given for the purpose of supplying to the Shire for the Community Growth Fund. Further, in providing the supplied content, you explicitly permit the collection and use of the supplied content by the Shire, which may be used, copied, stored, adapted, printed, published, advertised, promoted and/or reproduced without further notice, acknowledgment, remuneration or compensation.