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LEAF Local Environment Action Fund Application Form

To see detailed explanations on some of the questions please hover over the help symbol.

IMPORTANT NOTE: Please read the funding guidelines available here. You can contact the Environmental Education Team by email or phone on (06) 835-9200.

We MUST have an itemised quote to process your application. We prefer forms to be submitted electronically by clicking on the "BROWSE" button of the Funding Requirement question at the bottom of this form. If you do not have your quote in an electronic format and are unable to scan your quote into this format, please submit the application form electronically and post your quote seperately.

Name of your organisation

Contact Person

Job Title

Postal Address

Physical Address (if different to above)

Phone

Fax

Are you GST registered?

YesNo

GST Number

Who are you applying on behalf of?

If, you are a registered school or educational facility, how is your project linked to the curriculum?

If Other, please describe

Briefly describe the purpose of your organisation

Project Name

Briefly describe your project (up to 300 words)

Where possible, please provide street address details as well as regional location. The project MUST be within Hawke's Bay Regional Council boundaries. Please also state who owns the property.

Where is your project located?

Tell us how the project will involve the wider community, improve the quality of the region's environment and support one or more of our strategic Goals. Include curriculum links.

What are your project objectives

Is any promotional activity planned for the project?

YesNo

If yes, please describe any activity planned and how HBRC's contribution will be acknowledged.

You can request up to $500 for a single project. Please attach an itemised quote (from the supplier) to this application.

Funding requirement. Please see note at the top of the form.

You can request up to $500 for a single project. Please scan and attach an itemised quote (from the supplier) to this application.

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