First Name
Last Name
Phone
*
Email
*
Organisation legal name
*
Organisation
ABN or registration number
*
ABN / registration
Organisation type
*
Registered charity
Incorporated not-for-profit
Other eligible community organisation
Your position / authority to apply
*
Contact position
Organisation website or public profile
Website
Project title
*
Project title
Proposed project dates
*
Project dates
Which support stream(s) are you requesting?
*
Digital Support
Media Support
Creative Support
Event Support
Requested services and deliverables
*
Requested support
Community need and likely impact
*
Need and impact
Project plan, timing and feasibility
*
Project plan
Inclusion and community reach
*
Inclusion and reach
Capacity to deliver and cooperate
*
Delivery capacity
Other funding or confirmed support
Other support
AIM support received in the last 12 months
*
No
Yes
Unsure
Relevant relationship or conflict
*
None
Actual or potential conflict
Unsure
In case of conflict of interest, please explain below; otherwise, type NA
*
Project permissions and insurance status
*
All required items are held
Will be obtained before activity
Not yet confirmed
Applicant declaration
*
I agree
I do not agree
I need clarification
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