EXPRESSION OF INTEREST - Round 4 Would you like to be involved in the Valuing our Victorian Plains Incentive Program? If you have read the guidelines (attached) and think you are eligible then please complete this form. If unsure about eligibility, please contact: Rebecca Kootstra T: 527 4897 E: [email protected] PREVIOUS PARTICIPANTS (Please complete if you have participated in a previous round of this program) What round did you participate in (give year if unsure): ………………………………………………….. Please give a brief description of works and outcomes achieved so far, or where you are up to with your conservation management plan: …………………………………………..………………………………………………….. ………………………..………………………………………………..………………………………………………..……………………………… ………………..………………………………………………..………………………………………………..……………………………………… ………..………………………………….……………..……………………………………………………………………………………………… ……………………………………………………………………………………………..………………………………………………..………… ……………………………………..………………………………………………..………………………………………………..………………… ……………………………..………………………………………………..………………………………….……………..……………………… …………………………………………………………………………………………………………………………………………………………… This project is supported by Port Phillip and Westernport CMA, with funding from the Australian Government’s National Landcare Programme. 1. APPLICANT DETAILS Name: ………………………………………………………………………………………………………………………………….. Postal Address: ………………………………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………….................. Phone: ………………………………………….. Email: ………………………………………………………………………… 2. PROPERTY DETAILS Please provide details of the property or properties for which the funds are being requested. Owner Name: ……………………………………………………………………………………………………………………………………. Address of Property(s): …………………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………………………………………………........ ……………………………………………………………………………………………………………………………………………………........ Approx. Area for Works (Hectares): ………………………………………….. 3. PROPERTY DESCRIPTION Do you have native vegetation on your property? (This does not include areas that are on a river/stream bank or escarpment) o Yes o No Are those areas of native vegetation relatively unaffected by pasture improvement, cropping or other activity? (This does not include areas that are on a river/stream bank or escarpment) o o Yes No o Unsure How are those areas of native vegetation being managed now? o o Untouched Fenced o o Treated for weeds o Treated for pest animals Limited stock access Other: ……………………………………………………………………………………………………………………………………………… 4. WORKS REQUIRED FROM INCENTIVE PROGRAM The primary aim is protect the Valuing our Victorian Plains Incentive Program is to protect and improve biodiversity assets. Please indicate the actions that you think are required: o o Weed control Short-term stock exclusion o o Pest animal control o Controlled burns for weed and/or biodiversity purposes Long-term stock management Other: ………………………………………………………………………………………………………………………………………………. Please provide further details about the area/s that you would like to do works? (Describe the area, draw a map on the next page or add some photos – please attach extra pages if needed): …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… 5. FURTHER INFORMATION & TRAINING Are you interested in any further information or training to better manage indigenous grasslands? o Yes o No If yes, what would you like information or training about (eg. ecological burning, regeneration, grazing management, direct seeding or revegetation)? …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………………………… Draw a Map For any queries regarding the Valuing our Victorian Plains Incentive Program or for help completing this form, please contact the Council officer on the first page. Applications close: 12 August 2016 Please note: Late submissions will not be accepted.
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