HEAD OF CAMPUS
SMALL GRANTS & SPONSORSHIP FORM
>$500
This form should be used by community organisations or individuals requesting a small grant or sponsorship of generally less than $500
from a Head of Campus in your region. The applicant or organisation, or sponsored activity, must be located in the relevant campus
region to be eligible.
APPLICANT DETAILS
Applicant’s Name
Organisation
ABN
Address
Telephone
Email
GRANT REQUEST DETAILS
Grant Request
Amount
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$50
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$75
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$100
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$150
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$200
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$250
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$300
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$350
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Arts and Culture
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Environment
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Education
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Public lecture
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Other
$400
$450
$500
Date Funding
Required
Address
Telephone
Email
Grant Purpose
Conference
Sports
Regional development
Community Event
Older
Australians
Indigenous
opportunity
GRANT PURPOSE
Please tick here to show that you have attached no more
than half of one A4 page setting out the purpose of the
Grant and how you propose to acknowledge the UniversityCommunity Partnership Program.
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Young People
School needs
APPLICANT DETAILS
I understand that applications will be considered on their merits and that the University may not be able to support my request, or may agree to provide a
lower level of support than what I have requested. I understand that, should my application be successful, I will be responsible for reporting back briefly to
the Head of Campus in writing (email is sufficient) to advise of the outcome and benefits of the sponsorship. I understand that if I wish to use the CSU logo
or name I must obtain permission to use this in advance, and must not act in any way that may bring the University into disrepute. I understand that
information collected in this form becomes the property of the University and will be used to determine whether to approve the grant or sponsorship, and for
reporting on the grant to the Government, in CSU's Annual Report and other promotional materials. I consent to this use of the information in this form, and
any report submitted by myself in relation to this grant, by the University including my personal information.
Applicant’s Signature
Date
CSU OFFICE USE ONLY
Head of Campus Approval
Yes
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No
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Part Fund
Director OCA Noted
Date
Registration
Date
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Amount __________________