Funding agreement form

Contact details:

Organisation Name*:

Postal Address*:

ABN/ACN:

Name of project/event (must match application)*:

If you are requesting financial support for an event: Will your event have single use plastic water bottles for sale or will they be given away?
** Please note that any event sponsored by Westernport Water MUST be single-use plastic water bottle free. Failure to meet this requirement will result in sponsorship offer being withdrawn. —Please choose an option—Yes we WILL be selling or giving away single use plastic water bottles - Sorry we can not sponsor your eventNo we will NOT sell or give away single use plastic water bottlesProject - Not an Event

Sponsorship acknowledgement:

We will recognise Westernport Water through placement of Westernport Water logo on posters and marketing materials.*—Please choose an option—YesNo

Promotion: We will send copies of any marketing materials that include the Westernport Water logo to communications@westernportwater.com.au for approval, prior to publishing.*—Please choose an option—Yes, we will send marketing materials for approval prior to publishing.

Westernport Water will be recognised for sponsoring your project, initiative or event*—Please choose an option—Yes

We will recognise Westernport Water as a sponsor in any print, television or radio exposure.*—Please choose an option—YesNo

Where possible, we will recognise Westernport Water on any signage relating to the project, initiative or event*—Please choose an option—YesNo

We will recognise Westernport Water through acknowledgement at event by MC.*—Please choose an option—YesNoProject - Not an Event

We will recognise Westernport Water through acknowledgement via website and social media channels.*—Please choose an option—YesNo

We will recognise Westernport Water through other activities, please detail:

We agree to provide Westernport Water with photographs of our project, initiative or event suitable for use on social media, corporate publications and other promotional materials.*—Please choose an option—Yes, I agreeNo

*Photographs supplied to Westernport Water must be accompanied with a signed Photo Release Form. Download the form or email communications@westernportwater.com.au to request one to be emailed.

Funding Agreement:

We agree to use the funding provided by Westernport Water solely on the project, initiative or event outlined above.* —Please choose an option—Yes

We agree to use the funds in the 2023-24 financial year and return any unspent funding to Westernport Water.* —Please choose an option—Yes

If our project, initiative or event needs to be postponed/rescheduled beyond the 2023-24 financial year, we will notify Westernport Water as soon as possible.*—Please choose an option—Yes

We will notify Westernport Water as soon as possible and return any unspent monies if the project, initiative or event is cancelled.*—Please choose an option—Yes

I understand that this Funding Agreement must be returned prior to receiving any funding.*—Please choose an option—Yes

Please provide a tax invoice for the full funding amount using the upload fields below.
If we have asked you for additional quotes or evidence please attach them now.
(Invoices/receipts or signed statement of suppliers must be received prior to funding being released.*

*

I have uploaded documentation supporting this agreement form.*—Please choose an option—YesNo

I have read and understand the required Acquittal Form that must be returned within three months of the project, initiative or event completion, received no later than 2 May 2024.*—Please choose an option—Yes

I will provide evidence of sponsorship acknowledgement during and/or at the conclusion of the project. (eg newspaper clips, photos, social media posts, website mentions and signage*—Please choose an option—Yes

Funding Agreement Authorisation:

I am authorised to respond on behalf of the organisation.*—Please choose an option—Yes

I have read and understand this form.*—Please choose an option—YesNo

First name*:

Surname*:

Position/Title*:

Daytime telephone/Mobile*:

Email*

Your message (optional)

Declaration:*

By ticking this box, I declare that to the best of my ability the information provided in this application is true and correct and I am authorised to enter this agreement on behalf of my organisation.

Please leave this field empty.

Δ