Name of applicant (primary contact)
*
Email
*
example@example.com
Role within the group/organisation
*
Phone number
*
Name of group/organisation
*
Region
*
Please Select
Coromandel
Western Bay of Plenty
South Waikato
Taranaki
Manawatū
Whanganui
Wairarapa
Monetary amount required: (maximum of $5000.00)
*
Name of project
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell us about your group or organisation
Give us a brief description of the project or event
Which focus area does your project relate to? (see guidelines for more information about focus areas)
*
Community Wellbeing and Resilience
Connection, Inclusion and Belonging
Community Capability and Leadership
Environmental Sustainability and Stewardship
Outline how your project relates to this focus area
Is your project ready to be delivered once funding is confirmed?
*
Yes
No
Please outline a timeline of project delivery below confirming that it will be delivered within 6 months of receiving funding
What are the benefits of this project or event to the local community?
What other brands/businesses are supporting your project or event?
Please give us an estimated breakdown of how the funds will be utilised as part of this project?
Community Fund applications must provide at least 2 of the following benefits - please tick all that would apply:
Provision of exclusive and meaningful content for social media and other communications.
License for Powerco to create exclusive content for social media and other communications.
Space at event for an on-site activation.
Opportunities for our staff to volunteer and be involved.
Access to industry leaders and/or innovators particularly for the creation of content.
Other benefits we could pass along to our customers or other partners.
Advertising, advertorial or other distribution of our marketing materials to your target markets.
Have a high level of community involvement and participation.
How did you hear about this fund?
Facebook
Word of mouth
Community Engagement Advisor Dot
Community Engagement Advisor Salevi
The Powerco Panuni
Attach any supporting documentation, including a project plan.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
*
By signing this document, you agree to complete a progress report if the project takes over three months to deliver from the time of receiving the funds.
By signing this document you agree to complete a completion report within four weeks of delivering the project, including supporting images.
Agree that any personal information collected in this form will be used, stored and shared by Powerco in accordance with its Privacy Policy, which can be found at the bottom of this form.
I confirm that my group has a verified bank account that is linked to the organisation or community group that is applying for this funding.
Would you be happy for Powerco to send a photographer or videographer along to capture content to be used on our channels?
*
Yes
No
Do you have authorisation to apply for funding on behalf of the organisation?
*
Yes
No
Is your group/organisation GST registered?
*
Yes
No
If you are successful, would you be able to issue an invoice?
*
Yes
No
If no, then we will create a Buyer Created Invoice. Are you happy to be sent a BCI?
Yes
No
Would you like to sign up to our Powerco pānui?
Yes
No
Signature
*
Date
*
-
Month
-
Day
Year
Date
Please verify that you are human
*
Read our privacy policy
to learn how we collect, hold, use and share personal information.
Submit
Should be Empty: