Transport Heritage Grants Program
2015 Application Form
Application Deadline: 11:59pm, Monday 5 October 2015
IF COMPLETING BY HAND PLEASE USE BLOCK CAPITALS
APPLICANT INFORMATION
1. I/Our organisation has carefully read the 2015 Transport Heritage Grants Program guidelines and
criteria
Yes
2. Prior to lodging, I/Our organisation has discussed our application with:
THNSW
Royal Australian Historical Society (RAHS)
I/We have not discussed my/our application prior to lodging
NOTE: We cannot guarantee that your application will be considered if you/your organisation have not discussed your
eligibility to apply for a grant with RAHS or THNSW prior to lodging.
3. I am a Full Member of Transport Heritage NSW (to be completed by Individuals only)
Yes
No
NOTE: If you are applying as an individual and you are not a full member of THNSW, you
will be required to be approved as a member prior to submitting your application form.
Individuals who are not full members are ineligible.
4. Organisation Details (to be completed by Organisations only)
Name of organisation (ABN Registered Name)
Name of authorising officer (Chair/GM/CEO etc)
Mailing address
Phone number
Website
ABN
Is the organisation GST registered
Is the organisation not-for-profit
Year the organisation was formed
5. Contact person for this application (to be completed by Organisations & Individuals)
Title
Dr / Mr / Mrs / Ms / Other:
Name
Position (if applying for an organisation)
Mailing Address (individual applications only)
Phone Number
Mobile Number
Email
Website (individual applications only, if applicable)
Best time to reach you: (e.g. Mon-Fri, 10am-4pm)
PROJECT INFORMATION
6. Project Title:
7. Project Category (please select all that apply):
Restoration and Conservation (open to eligible organisations only)
Sustainable activities of a transport heritage organisation which directly involve the restoration and/or
conservation of a Government or non-Government owned transport heritage asset (rail, tram or bus) which
is not eligible for other Government funding.
Education (open to eligible organisations for transport heritage activities only)
Activities which involve educating the community about transport heritage or the operation of transport
heritage passenger services only e.g. programs promoting the history and/or facilities of the group to local
schools and/or community groups AND/OR
Programs designed for local schools developed in conjunction with educational staff, have the written
support of local education authorities and contribute to the history curriculum delivered by the school.
Research and Publication (open to eligible organisations and full members of THNSW)
Innovative digital research and print interpretation about the people, culture, knowledge or skills and/or
events of NSW transport heritage or other applicable historical highlights of NSW transport heritage to
assist with educating the community.
8. Is your project linked to a:
Privately owned heritage asset (please include the necessary proof of ownership)
Government owned heritage asset (please include Custody Management Agreement)
9. Please outline the aims, rationale and intended outcome/s of the project, including the transport
heritage significance of the project :
Please respond in no more than 500 words. A separate sheet may be attached if required.
10. How will your project be relevant and useful to your target audience, and/ or benefit the community or
the preservation of transport heritage in NSW?
Please respond in no more than 500 words. A separate sheet may be attached if required.
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11. Please outline why your organisation/you are undertaking this project, where your project is located
and how your project will be viably conducted:
Please respond in no more than 500 words. A separate sheet may be attached if required.
12. How will the community participate in or engage with the project?
Please respond in no more than 500 words. A separate sheet may be attached if required.
13. If applying for an activity under the Restoration and Conservation category, please detail how it will
fulfil the additional Heritage Asset Grant Criteria:
Heritage value of the asset/s
Overall condition of the asset/s
Use and purpose of the asset/s
Value for money
Project management capability and
capacity of the custodian
Availability of parts, equipment,
volunteer and paid staff required to
undertake your project
TIMEFRAME AND KEY MILESTONES
14. When did the project start or when it is due to start?
Start Date:
15. Approximate date you expect the project to be completed:
Note: projects cannot be completed before 22 November 2015 (grant presentation ceremony).
End Date (approx. Month/Year)
16. Have steps already been undertaken for the project?
No
Yes, the steps which have already been undertaken are:
<insert dot points here>
17. List the target milestones for the project:
NOTE: You are only required to note milestones that will be completed within the allocated funding timeframe. If there is not
sufficient space below you can attach an additional document or clearly provide this information a in a separate Project Plan.
#
Project milestone
Critical path tasks
1
2
3
4
5
6
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Time estimate
Expected completion
date (month/year)
18. If your project is scheduled to take more than one year to complete, please specify how you/your
organisation intends to fund it after the one year grant period.
NOTE: If you are awarded a 2015 grant and successfully fulfil the funding criteria during the funding year, you may be eligible
to reapply for a grant to continue the project in the next program cycle. If you do not successfully complete your project in
2015 you will not be eligible to reapply for a grant to assist with the same project in 2016.
PROJECT BUDGET AND FUNDING SOURCES
19. What is the estimated value of work performed (paid and volunteer)?
Please list the roles, hours, and hourly rate value for both paid and volunteer workers. The recommended estimated
equivalent hourly rate for volunteers is $30/hour if no other value is available.
Role description
Role type
(paid / volunteer)
Estimated hours
Hourly rate
TOTAL
(actual / estimate)
20. Have you/your organisation received any other grants in the last two years?
Yes
If yes, please provide details for other grants:
Source:
Year:
Amount:
Project description:
No
21. Please provide an estimated budget by funding source:
When filling out the project budget table, please include a full and considered breakdown of all expenses and income relevant
to your project. You can attach more detail in a separate budget document if required, or clearly provide this information in a
separate project plan.
Task, activity or
materials
Applicant’s
contribution
Other
contributions
(include source)
Grants Program
funding request
(including GST)
TOTAL
1.
$
$
$
$
2.
$
$
$
$
3.
$
$
$
$
4.
$
$
$
$
5.
$
$
$
$
Total grant amount requested (including GST)
$
22. If you are not successful in your current application, how do you intend to continue with the project?
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SUPPORTING ATTACHMENTS
Budget: a comprehensive budget for large scale projects and/or key milestones if requesting over
$3,000 (indicative quotes to support such proposals will assist your application)
Constitution: the objectives, constitution and rules of your organisation if you are not affiliated with
THNSW
Proof of ownership: is required if applying for a Grant to assist with a privately owned heritage asset
Asset management agreement: if you are applying for a Grant to assist with a Government owned
asset (licence, CMA, other)
Proof of prior approval to commence work: if applying for Restoration and Conservation Project
please ensure all necessary approvals have been sought prior to application and ALL relevant proof of
approval to commence work (e.g. from your local council) are attached.
Safety accreditation: If the project relates to an operational asset, please provide evidence of
accreditation by the National Rail Safety Regulator including the Operators’ Safety Management System
(SMS)
Insurance certificate/s: evidence of any insurance policy/s you have for Public Liability, Professional
Indemnity, Workers’ Compensation or other policy relevant to your project.
Relevant images if you are including photographs ensure to include full source details
Letters of support and/or CVs: required to support applications for Individuals
APPLICANT DECLARATION
In submitting this application, I acknowledge that I have read and understood the Application Guidelines for the 2015
Transport Heritage Grants Program, and I understand that information in my application may be disclosed to RAHS,
THNSW, reviewers and staff assisting with the administration or promotion of this grant program, and members of
Parliament and their staff for promotional purposes.
If applying on behalf of an organisation, I confirm that I have the appropriate delegation to do so.
Applicant name, signature and date
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