Funding Applications

Name of Applicant Organisation:

Physical Address
Address 1:
Address 2:
City: Post Code: Postcode Finder  
Click here to copy your physical address to postal address

Postal Address
Address 1:
Address 2:
City: Post Code: Postcode Finder
Telephone Number:
Email Address:
Two contact names, personal addresses and telephone numbers (business and after hours) required.

NameAddressBusiness PhoneAfter Hours Phone

What is the purpose of your organisation?  

Is the applicant group registered for GST?
If yes, please supply the number (see notes on GST on final page)
GST No:

Does the applicant group have IRD Charitable Status?
IRD No:

Is the applicant group an Incorporated Society?
(Affix common seal or include certificate of incorporation)
CC No: