Whanau Ora Funding Application

Whanau Ora Funding Application
Organization Name
Contact Name
First NameLast Name
Job Position/Title
Phone Number
Area CodePhone Number
Email Address
example@example.com
Office Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Organization Goals and Objectives for year 2020

Project Name/Title
Project Description
Reasons why the organization needs funding:
Where are you normally getting your funding for your organization?
What is the focus of your funding? Please explain it below:
What is the long-term goals of your organization?
Where will the funding be mainly used?
Financial Budget ($) vs Requested Fund ($)
Financial Budget ($) Requested Fund ($)
Facilitation and Preparation
Consultation
Development and Completion
Total Requested Fund ($)
Reminder: Funding cannot be used for payment of existing debts, overseas travel, activities that are only beneficial for a single person, salaries, or rents.

By signing below, you acknowledge that this form will collect the information about your organization and used it as a basis for approval. The information will be used for statistical purposes. The applicant (representative/organization) will take accountability for all essential docunent related to this project.
Whanau Representative Name
First NameLast Name
Whānau Representative Signature
Clear
Date Signed
MonthDayYear
Date
Authorized Person Name
First NameLast Name
Authorized Person Signature
Clear
Date Signed
MonthDayYear
Date
Should be Empty:

	Financial Budget ($)	Requested Fund ($)
Facilitation and Preparation
Consultation
Development and Completion