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Funding Application
If you would like to submit an application for funding assistance to the Trustees, please complete the Request for Funding Application Form below.
Name of Applicant/Organisation
Key Contact Person
Key Contact Person Phone Number (no spaces)
Key Contact Person Email
Mailing Address
Background of Programme/Product/Service
Development of Programme/Product/Service
Utilisation of Funds
Total Amount Requested
How will you report on progress/outcome?
How will the health and wellbeing of New Zealand Communities benefit from this Programme/Product/Service?
Have you sought funding from any other organisation?
Are you aware of any conflict of interest?
Are you aware of any ethical issues pertaining to this application?
Your Name
Dated:
SUBMIT
