FUNDING APPLICATION FORM
LOCAL COMMUNITY EVENTS
Please contact the QLDC Events Office to discuss your event PRIOR to completing this application form.
Please also ensure that you:
Read the Events Strategy which are provided on the QLDC Website.
All Applications must be submitted digitally – you must complete this form, save and return via email to
[email protected]
All the supporting documentation as per the checklist in section six of this application form must also be
submitted digitally via email to [email protected].
DO NOT WRITE ‘See Attached’ as an answer to any question in this Application Form. If there is insufficient
room, please provide a summary on the application form in the box provided, and provide further details if
necessary as part of your supporting information.
If however your application is incomplete when received by our office, it may be returned to you, which will
inevitably delay any decision.
Queenstown Lakes District Council
Tel: 03 441 0499
10 Gorge Road
Private Bag 50072
Queenstown
Email: [email protected]
www.qldc.govt.nz
QLDC Events Funding Application - Local Community v1-2015
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1. APPLICANT INFORMATION
1.1
Contact Details
Name of Organisation
Contact Name
Title
Address
Telephone
Mobile
E-Mail
Website
1.2
Organisation Details
a. How long has your organisation been in existence (tick):
Less than 1 year
2-3 years
4-5 years
More than 5 years
b. Legal Status of Applicant (tick):
Charitable Trust
Incorporated Society
Limited Liability Company
Other (please specify):
c. Taxation Status of Applicant (tick):
Tax Exempt Organisation
Tax Paying Organisation
Non-Profit Organisation
Other (please specify):
d. Is Applicant/Organisation GST Registered (tick):
Yes
No
e. Event Organiser / Owner / Promoter (if different from Funding Applicant):
Name of Organisation
Contact Name
Title
Address
Telephone
Mobile
E-Mail
Website
QLDC Events Funding Application - Local Community v1-2015
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f. Does the event owner/organiser have previous experience in event management (tick):
Yes
No
If yes, please detail past events, outline key objectives and outcomes illustrating success of events
and accomplishments (up to 200 words - attach additional information as required):
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2. EVENT INFORMATION
2.1
Name of Event:
2.2
Event Summary:
Please describe your event and outline what you believe makes it ‘great’
(up to 200 words - attach additional information as required):
2.3
Event Objectives:
Please outline the main reasons this event is being held and your objectives as the Event
Manager/Promoter (up to 200 words - attach additional information as required):
2.4
Date(s) of Event:
From
2.5
Event Duration (Days):
2.6
Has the Event been held before (tick):
Yes
No
If Yes, when, where and how successful was the event (please provide detail backed by references/
testimonials where available (up to 200 words - attach additional information as required):
2.7
What is the frequency of the event (tick):
Annual (every year)
Biennial (every two years)
A one-off Event
A limited season event (e.g. every year for three years only)
Other – Specify:
To
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2.8
2.9
Where will the event be held:
Please specify town(s) (tick):
Arrowtown
Hawea
Makarora
Wanaka
Please specify Venue(s) (tick):
QLDC Venues
Arrowtown Athenaeum Hall
Lake Wanaka Centre
Queenstown Memorial Centre
Gardens and Green Spaces
Queenstown
Earnslaw Park
Queenstown Village Green
Queenstown Recreation Ground
Lake Hayes Show Grounds
Arrowtown
Butlers Green
Library Green
Millbrook Corner
Wanaka
Wanaka Station Park
Dinosaur Playground
Allenby Park
Glenorchy
Kingston
Queenstown
Other – Specify:
Lake Hayes Pavilion
Queenstown Events Centre
St Omer Park
Queenstown Gardens
Jacks Point Field
Buckingham Green
Jack Reid Park
Pembroke Park
Wanaka Recreation Reserve
Peter Fraser Park in Lake Hawea
Streets and Other Public Spaces – Specify:
Please provide route/course maps where appropriate
Other – Specify:
2.10
Please advise what plans are currently in place for the event (please note, all plans must be made
available on request)
Event Delivery Plan
Business Plan
Marketing Plan
Budget and Financial Forecasts
Health & Safety Plan
Traffic Management Plan
Waste Management Plan
Contingency Plan
Risk Mitigation Plan
Crisis Management Plan
Other (please specify):
Notes:
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3. FUNDING INFORMATION
3.1
What is the total projected event expenditure:
3.2
What is the total projected event revenue:
(excluding any QLDC funding or in-kind support)
3.3
What is the amount sought from QLDC:
(amount sought cannot exceed 25% of total budget expenditure)
3.4
If successful, please list and describe specific event expenses/costs to which QLDC funding will be
applied (up to 200 words):
3.5
Please outline the event income structure:
Funding Agency/Supporter
Value
Dollar value of event income from outside the district?
Event expenditure within district?
Dollar value of event income from users/attendees/participants?
Dollar value of event income from ticket sales?
Dollar value of event income from sales at event (food stalls, alcohol,
merchandise, etc.)
Dollar value of event income from Sponsorship (cash and in-kind)?
Dollar value of event income from donations/patrons (no "strings
attached")?
Dollar value of event income from funding agencies
(local/regional/national)
Dollar value of event income from QLDC funding/in-kind support?
Dollar value of event income from other sources?
3.6
What Grants/Community Funding/Central Government support (cash and in-kind) has been
sought and/or confirmed for the event.
(please specify names of supporters and dollar values sought/confirmed):
Funding Agency/Supporter
Cash Value
In-Kind Value
Confirmed (Y/N)
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3.7
What sponsorship (cash and in-kind) has been sought and/or confirmed for the event.
(please specify names of sponsors and dollar values sought/confirmed):
Sponsor
Cash Value
In-Kind Value
Confirmed (Y/N)
3.8
Are you receiving any QLDC support towards this event (e.g. Annual Plan Funding, Commercial
Ratepayer Funding):
Yes
No
If Yes, please explain (up to 200 words):
Please note you must provide a full and complete budget for the event in order for your application to be
considered
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4. SOCIAL AND COMMUNITY BENEFITS
4.1
How many volunteers are involved with your event and where do they come from:
Origin
Number of Volunteers
Local
Within District
Regional (300km Radius)
National
International
Total:
4.2
What benefits does this event provide or generate for the local community and surrounding
district (up to 200 words):
4.3
Does the event promote high achievement and participation for residents in any of the following
fields (tick):
Arts/Culture
Sporting
Leisure
Other – Specify:
4.4
Does the event profile New Zealand or regional culture and heritage and is this cultural heritage
unique (tick):
Yes
No
If yes, please explain (up to 200 words):
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4.5
Does the event provide a programme of activities that allows for local participation, provides
educational opportunities or showcases local achievements:
Yes
No
If yes, please explain (up to 200 words):
4.6
Please outline what you believe to be the legacy of this event for the local community (pride,
identity, participation, economy (up to 200 words):
5. ENVIRONMENTAL IMPACT
5.1
Describe what efforts are being made towards minimising the impact of this event on the
environment and making the event more environmentally sustainable.
Consider energy and water conservation, returning the site after the event, waste management,
recycling, noise, traffic management, etc. (up to 200 words):
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6. SUPPORTING MATERIAL
Please ensure you have provided the following supporting information with your application.
All documents are to be transmitted electronically.
Certificate of Incorporation / Trust Deed (if you have submitted this with a previous application
and there have not been any changes, we do not require this again)
Information about people involved in the Project List committee members and/or key event staff
and their roles and relevant experience
Previous Outcomes
If the event has been staged before, please provide details of key outcomes and achievements,
event photos, reports (economic impact, event surveys, ASR), audited financial accounts and
testimonials.
Any Letters of Support from key stakeholders, suppliers and sponsors
Quotes for Service where funding is to be allocated to specific costs
Copy of QLDC Hire Agreement (if available)
Copy of QLDC Resource Consent and Permits (if applicable)
7. STATUTORY DECLARATION
Please print, sign, scan and return this page with your application.
The Chairman, CEO or authorised representative of the Event Organiser shall execute this Statutory
Declaration that the information contained in the Application is true and correct in all respects.
I/We
Full Name of Declarant(s)
Of
Address of Declarant
Position in Organisation
Name of Organisation
Confirm that
Name of Organisation
Has formally applied for funding under Queenstown Lakes District Council’s Event Fund and I confirm
and warrant that to my knowledge the details set out in the Application are true and correct in all
respects.
Signature
QLDC Events Funding Application - Local Community v1-2015
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