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Application checklistPlease read the Get Playing Guidelines and other support materials available on the department’s website (www.nprsr.qld.gov.au/getinthegame) and complete the following checklist prior to filling in the application form.
Have you read the guidelines for the program? This will assist you in clearly understanding the objectives of the program and whether your organisation and/or your project is eligible for funding under Get Playing.
Organisation requirementsDo you know the following details of your organisation: legal name, ABN, Incorporation Number/Australian Company Number, whether registered for GST, postal address, street addresses and accountable officer details?
Does your organisation have any outstanding issues with your incorporation requirements, e.g. are you compliant with the Office of Fair Trading?
If you have any projects already funded by the department, have you met all of the department’s requirements for the project/s?
If you have junior members, have you registered your organisation for Get Started?
Project requirements (visit the planning section on the Get Playing website www.nprsr.qld.gov.au/funding/getinthegame/getplaying)
Do you have the following documentation?Land tenure (i.e. a copy of Certificate of Title)Lease/right to occupy documents (which can indicate at least a three year commitment to use the land for sport/recreation activities)Land owner’s permission to undertake your project
If your project is to be constructed on land controlled by an educational institution, do you have support from the relevant authority at the school or university chancellor?
If on state school land, do you have the following?
A Department of Education, Training and Employment approval letter from at least the Regional Facilities Officer (you will also require formal departmental approval, should the project be approved)
A Community Use Agreement
Do you have a copy of the sketch design and site plan?
Have you verified project costs (through three quotes or a quantity surveyor’s estimate)?
Have you confirmed your sources of funding and/or have details of all in-kind contributions for your proposed project?
Have you clearly determined the project need in supporting participation in sport and recreation activities by your members?
Do you have supporting documentation for your project, such as:letters of commitment from user groupscurrent and proposed activities for the facilityconsultation details.
Have you contacted your council to discuss the project?
Will this project require Building Approval?Do you need to obtain Development Approval before the project can commence?
Have you lodged/received Development Approval? (if applicable)
Have you considered the operation and maintenance of your proposed project and the ongoing cost for your organisation? Information is available on the department’s website (www.nprsr.qld.gov.au/funding/getinthegame/getplaying) to assist you to estimate the type of costs you may need to consider, and whether your organisation is able to continue to maintain the project once completed.
You are advised to contact your nearest Sport and Recreation Services office to discuss your project prior to submitting an application. Contact details can be found on the department’s website at www.nprsr.qld.gov.au/contactus/offices or by telephoning 1300 656 191.
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This application form is for Get Playing. Organisations may only apply for one project per location under this program. Refer to the guidelines for the program at www.nprsr.qld.gov.au /getinthegame .
Organisation details1 Applicant organisation detailsFull legal/incorporated name
Full legal/Incorporated name
ABN (If your application is approved you will require a ABN)
Incorporation Number/Australian Company Number
GST registered? Yes No
Postal address
Postal address
Suburb/town
State/postcode
Street address
Postal address
Suburb/town
State/postcode
Organisation Contact details
Telephone
Fax
Email address
Accountable officer (e.g. President, Chief Executive Officer, Management Committee Member - all correspondence will be sent to this person)
Mr/Mrs/Ms/Miss
Full name
Job title
Telephone Mobile
Fax
Email address
Under which Act is the organisation incorporated? (Tick the relevant box)
Associations Incorporation Act 1981 (Qld)
Corporations Act 2001 (Cwlth)
Cooperatives Act 2002 (Cwlth)
Corporations (Aboriginal and Torres Strait Islander) Act 2006 (Cwlth)
Local Government Act 2009 (Qld)
Other (please specify)
2 Does your organisation provide sport/recreation activities for children and young people from the age of 5 and under the age of 18? (junior members)
Yes (continue to question 3)
Yes, but we do not have members that join our organisation (e.g. regional association) (continue to Project details, question 4)
No (continue to question 4)
3 If you answered ‘Yes’ above (and have junior members), has your organisation registered for Get Started? Yes (continue to next section)
No - your club is not eligible for funding under Get Playing until registered for Get Started. Please review the Get Playing program guidelines or contact your nearest regional office on 1300 656 191
4 Has your organisation consulted with Sport and Recreation Services advisor? (Refer to page 13 of guidelines)
Yes
No
Project details5 Who is the contact person for this project? (If the same as accountable officer, put ‘as above’.)
Mr/Mrs/Ms/Miss
Full name
Job title
Telephone Mobile
Fax Email address
6 What are the Lot and Plan numbers for the project?Lot number Plan number
7 What is the physical address of the project?
No./Park name
Street address
Suburb/town
State QLD Postcode
8 Describe the project you are applying for. (word limit of 100 words)
e.g. Construct a new multi-sport court for tennis, netball, basketball and volleyball at Mt Gravatt.
9 Have you attached a copy of land tenure documentation? Yes*
No (your project is not eligible)
*For projects on state school land you must provide a letter from the Regional Facilities Officer stating that Education Queensland approves the construction of the project.
10 Have you attached a copy of a lease/right to occupy arrangements over the land for at least three years? Yes
No (your project is not eligible)
N/A – land is owned by the club
11 Have you attached a copy of permission to build from the land owner? Yes
No (your project is not eligible)
N/A – own the land
12 Have you attached a sketch design of what you intend to build and a site plan that identifies the location of the new facility?
Sketch design
Yes
No (your project is not eligible)
Site plan (including site boundaries)
Yes
No (your project is not eligible)
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13 Complete the following table, providing the overall project cost, including the scope of works required. Costs must be listed as GST exclusive where applicable. (Organisations not registered for GST will need to consider the impact of GST on the overall costs of delivering the project, as the GST component of project costs cannot be claimed when acquitting the funding. Any funds unspent by organisations not registered for GST will need to be refunded to the department as a GST exclusive amount). Note: In-kind contributions need to be included when calculating the total project costs but cannot be part of the funding requested.
PROJECT ACTIVITY(include description of works and list suppliers’ quotes
for each item of works if not in-kind)
QUOTES PROJECT COSTS(GST
exclusive)WORKS SUPPLIER NAME QUOTE TOTAL
(GST exclusive)PREFERRED (if
applicable)
e.g. Site workse.g. Get-a-Digger excavation $6,000
$4,900e.g. A plus excavation $5,500e.g. Budget Dig n Move $4,900
$
$ $ $
$
$ $ $
$
$ $ $
$
$ $ $
$
$ $ $
$
$ $ $
In-kind contributions (provide breakdown in question 15)Total in-kind contributions $ Other (please specify)Departmental signage (eligible for funding up to $1,000) $ $ $ $ Professional fees $ $ $ Building escalation (if applicable) $ $ Contingency (allow approximately 5-10%) $ Statutory fees and charges $ $
Total eligible cost (GST exclusive) (A) $ Ineligible Items $ $ $
Total ineligible cost (GST exclusive) (B) $ TOTAL PROJECT COSTS (GST exclusive) (A+B) $
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14 If you have not been able to provide three quotes or a professional quantity surveyor’s estimate for the works above, please provide a reason why.
15 If your preferred quote(s) is not the lowest priced quote, explain why the lowest priced quote is not preferred (Note: the department will use the lowest quote if a reasonable explanation is not provided.)
16 Provide a breakdown of in-kind donations of services, goods and volunteer support that have been included in the project costs in question 12. (Provide copies of letters confirming donations and in-kind labour provided by volunteers.)
Task Name/s of those supervising task and qualification
In-kind support Number of hours/days
Rate per hour/day
Total cost
(excluding GST)
e.g. Donation of bricks
Craig T, Builder (Brick supplier)
Building bricks (5000) NA NA $2,525
e.g. Building works labour
John S, Builder (builder)
Club volunteer labour support x 5 volunteers
100 hours $25/hour $2,500
$ $
$ $
$ $
$ $
$ $
$ $
$ $
Total cost (excluding GST) $
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17 Provide details of how your organisation will fund its contribution towards the cost of the project.You need to attach written evidence of the funding sources you have identified and provide documentation confirming the sources of funding (e.g. a recent bank statement, letter from your lender(s) confirming a loan and/or letter confirming cash donation).
Source of funds Details Amount $
Organisation’s financial contribution (allocated for the project)
$
In-kind contributions $
Loans (provide name of institution) $
Commonwealth Government Grants – Capital (confirmed)
$
Local Government Grants – Capital (confirmed)
$
Queensland Treasury Corporation Loan (confirmed)
$
Cash donations for project $
Your organisation’s total contribution (GST exclusive) $
Other state government* funding (including any funding from the Department of Education, Training and Employment)
$
$
$
Total funding requested from department (GST exclusive)
(Must be no greater than 80% of total eligible project cost – refer to guidelines)
$
*Funding from other state government agencies will reduce the amount of funding available from the department by the same amount.
Organisations not registered for GST will need to consider the impact of GST on the overall costs for delivering the project, as the GST component of project costs cannot be claimed when acquitting the funding. Any unspent funds will need to be refunded to the department as a GST exclusive amount.
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Program priorities18 What type of project are you seeking funding for?
New participation space
Upgrade to existing participation space
Not a participation space
19 (a) Will your project provide facilities that attract, retain and/or accommodate female participation?
Yes
No (continue to question 19)
(b) Describe how your project can better enable women’s and girls’ participation at your facility?Some of the enablers to women’s and girls’ participation include, but are not limited to: improved access to venues and places to participate safe and comfortable locations culturally appropriate facilities.
Need20 Clearly identify how the proposed project will address the program objectives through:
developing or improving facilities to support active club membership; and/or addressing current and future community demand for your club’s facilities; and/or encouraging Queenslanders to become active members of your club.
21 Outline the current and expected use of your facility:Membership details (refer to definitions of ‘members’ outlined in the guidelines section 3 and 14).
Member type 2013 Members(last year)
2014 Members(current)
2015 Members (estimated)
2016 Members (estimated)
Female Male Female Male Female Male Female
Male
Senior members
Junior members
Program participants
Event participants
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Existing facilities and usersFacilities at the site or in nearby community
Current user groups of the facility
Membership/user trends
Activities and usage rates for the facilityCurrent seasonal/annual activities at current facility
Sport/recreation activity Months/Year
Current Projected
Current weekly usage
Activity Monday Tuesday Wednesday Thursday Friday Saturday Sunday
e.g. basketball training4-6pm
training4-6pm
games4-6pm
games4-6pm
training4-6pm
training9am-4pm
games9am-4pm
Estimated future weekly usage
Activity Monday Tuesday Wednesday Thursday Friday Saturday Sunday
e.g. basketball training4-8pm
training4-8pm
games4-10pm
games4-10pm
training4-10pm
training9am-8pm
games9am-8pm
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22 Who did you consult with to determine the need for your project?In responding to these questions, provide all relevant supporting documentation. Examples may include:
minutes of meetings community surveys letters of commitment from current and future users.
Who did you consult? What interest does this organisation have in the project?
What involvement/commitment do they have in this project?
Local council
Who?
Sporting club/s
Who?
State level organisation/s
Who?
Community organisation/s
Who?
Local community
Who?
Local school/s
Who?
Others
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Ability to deliver23 Do you need Development Approval for your project?
Yes – received (attach documentation)
Yes – lodged and awaiting decision (provide evidence of lodgment or IDAS self-assessment)
Yes – required and yet to lodge
Not required (provide a letter from a council planning officer stating it is not required)
24 What are the tasks you need to undertake to complete the project?Complete the following table to provide an indication of key milestones for the project. Planning for the project can begin prior to the funding round, however, the project must occur between 1 January 2015 and 31 December 2015.
Task Responsible person
Estimated start date
Estimated finish date
Engage a project manager (if applicable)
Conduct site investigation
Obtain development approval (if applicable)
Finalise design documentation
Obtain building approval (if applicable)
Obtain quotes
Begin construction
Complete construction
Open facility for public use
Complete project (must be by 31 December 2015)
Acquit funding (must be by 31 January 2016)
25 Have you considered the operational and maintenance costs, and additional charges, for the new project and the impact on your organisation?
Yes, the organisation is aware of the ongoing costs for the new project and is able to meet these obligations
No, the organisation has not considered how the ongoing costs will be met in the future
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Application checklistHave you completed the checklist at the front of this application form?Have you submitted the whole application form?Have you checked that all attachments are fully secured to your application/ provided with the application?Have you kept a photocopy/electronic copy of all documentation for your own records?Have you considered the timeframes and who will be responsible for ensuring the project will be delivered, should it be funded?
Have you confirmed your contributions and provided evidence with your application?
Have two member’s of your organisation’s management committee signed the Declaration?
Feedback How long did it take you to complete the application form (not including preparation time for the project)?
mins.
How simple was it to complete the application form?
Extremely complex Complex Neutral Simple Extremely simple
How easy did you find the application process for your project (including planning)?
Extremely difficult Difficult Neutral Easy Extremely easy
DeclarationTwo members of your organisation’s management committee are required to complete the details below and sign for and on behalf of your organisation.
We declare that we are authorised by the applicant organisation to submit this Application for Funding under Get Playing.
We declare that all information relating to the organisation and the project is true and correct.
Name
Position
Signature
Date
Name
Position
Signature
Date
Organisation contact details will be included in a database for future mailouts and emails. If you do not wish to receive this information, please tick the box below:
I would not like to be included in a mailing list for further mail outs and emails about the department's services and initiatives in my local area.
PRIVACY NOTICEThe Department of National Parks, Recreation, Sport and Racing is collecting the information on this form to assess applications for funding under Get Playing. Information will also be used to help the department monitor and evaluate programs and resources. This information will only be accessed by authorised employees within the department. The department will disclose details of approved funding and details of accountable officers (such as name, position in the organisation, and telephone number) to local members of Parliament. Information on approved organisations and details of approved projects, such as funding approved and location of the project will also be made available on the department’s website and may be provided to local governments and relevant sport and recreation organisations for the purpose of advice on approved project information. Your information will not be disclosed to any other parties unless authorised or required by law.
If you have any further questions regarding privacy, please contact the department’s Privacy Contact Officer at privacy@nprsr.qld.gov.au.
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