Community partnership application

Contact Details

Organisation name *

ABN *

Given name/s *

Family name *

Position *

Phone number *

Email *

Organisation details

Is your organisation not-for-profit? *

Please note: this program supports not-for-profit organisations as a preference.

• Yes
• No

About your organisation * Tell us who you are, what you stand for and what you want to achieve – in no more than two sentences.

How will your initiative make a difference to the lives of Territorians? * In no more than two sentences.

Event or program details

Why are you applying for funding? What will you do with the funding? * This is your chance to tell us all about what you would like to achieve, sell us the dream. Be specific with how you would spend the grant funds, with tangible outcomes rather than just expanding a current program/initiative.

How much funding are you requesting to deliver your initiative? * Please include the amount and a clear description of how it will be spent. Requests are assessed against our purpose and initiatives, the impact for Territory, and the overall partnerships budget.

Have you received support for funding from us before? *

• Yes
• No

If you need to provide more information please do so here. Think objectives, audience, background information, location and duration.

Partnership benefits

Which Power and Water key initiatives does your application align to? Select all that apply. *

• Helping shape the future of the Territory
• Caring and supporting Territorians
• Uplifting or creating opportunities for Territorians

How does your project contribute to the selected initiative(s) and what positive outcomes will it create for Territorians? * Explain how your project supports the selected initiative(s) and describe the expected benefits for Territorians.

How can Power and Water actively contribute beyond funding? * For example, consider opportunities such as volunteering, mentoring and education, technical expertise, speaking opportunities, STEM or career engagement, community conversations, participation at events, or cultural learning opportunities.

How will you work with Power and Water to celebrate outcomes and share the impact of the partnership throughout its lifecycle? * Examples include joint storytelling, social media, newsletters, photography or video, media opportunities, case studies, community stories and employee stories.

Are you seeking funding from other sources for this event or program? *

• Yes
• No

Do you agree to complete a formal evaluation of the partnership following your event or program? *

• Yes
• No

How did you hear about the community partnership program? *

• The website
• Social media
• Word of mouth – referral
• Power and Water employee
• Other

Please attach any supporting documents or formal proposals here

Privacy

Disclaimer *

• Power and Water follows the Australian Privacy Principles (APPs) as prescribed in the Privacy Act 1988 (Cth) and the relevant Information Privacy Principles (IPPs) set out in the Information Act (NT), in its commitment to the protection of your personal information. Information you provide on this form will be collected, used and stored for the sole purpose of this partnership request. Your personal information will not be disclosed to any third party unless formally stated in a partnership agreement.
  
  For more information see www.powerwater.com.au/privacy