City of Subiaco - Youth Achievement Grant application

If you are applying solely to support the purchase of goods or equipment, please attach proof of purchase. Applications based solely on purchase of goods or equipment must be made no later than 60 days from date of purchase.

Applicant details
Name:
Age:
Date of birth:
Residential address:
Suburb:
Email:
Phone:
Application category:	I am a resident of the City of Subiaco I attend school within the City of Subiaco
Proof of enrolment:	Upload file If you are applying on the basis that you attend school within the City of Subiaco, you must attach proof of enrolment.
Activity details
Activity title:
Date of activity:
Location:
Brief description of activity:
Grant expenditure
Amount you are requesting:	Non-location based, remote or online ($100) Within WA ($100) Interstate ($200)
Brief description of expenditure:	e.g. fees, equipment, uniform and project costs
Support of application
Contact person:
Position:
Organisation:
Phone:
Evidence of participation:	Upload file Please attach a letter of support from an associated organisation, evidence of participation or enrolment.
Proof of purchase:	Upload file If you are applying solely to support the purchase of goods or equipment, please attach proof of purchase. Applications based solely on purchase of goods or equipment must be made no later than 60 days from date of purchase.
Payment details
Completed payment details form:	Upload file
Copy of bank details or statement:	Upload file
Declaration
The information provided in this application is correct:
If successful, the grant provided by the City of Subiaco will be expended in accordance with details in this application:
If under the age of 18, I declare that I have my parent/guardian consent for this application and consent that the payment will be made into their account:
I am aware the maximum grant amount that can be received within 12 months is $400:
The grant is not being paid to a club administrator, trainer or coach:

Youth Achievement Grant application

Applicant details

Activity details

Grant expenditure

Support of application

Payment details

Declaration