CommunityCare Fund expression of interest form

Project title *

Location / address of the project *

You may provide a location by dropping a pin on the map. To do this, simply scroll to the correct location and click or select within the map to drop a pin. If you need to remove a pin, simply click or select it. If you prefer to provide a street address, you may do so in the box immediately below the map.

Total project cost *

Please enter the amount only (no text) and do not include a $ sign

Total funding request *

Please enter the amount only - i.e. numbers, a comma and any decimal point. Do not include a $ sign or any text. In accordance with the funding criteria, the grant amount you request here must be between 5,000 and 50,000. Transpower’s CommunityCare fund allocations are classed as grants (not donations). If you are not GST registered, the grant amount you request should include GST. If you are GST registered, the grant amount you are requesting should exclude GST. Please bear this in mind when filling out the Total Funding Request (the grant amount you are applying for) above.

Have you requested funding from another source for this project? *

Yes

No

If yes, please outline the source of the funding and the amount applied for and/or secured.

CommunityCare Fund expression of interest form

The application process