Application Form Sample
Application Form Sample
Application Information
CFC services provide access to free, confidential and non-judgmental information, advice and advocacy to
eligible people experiencing financial difficulty.
FC services help people to build financial skills, knowledge and capabilities. Services should be tailored to
the needs of individuals, families and communities within the organisation's service area(s), including cultural,
geographic and other specific needs. Services should focus on early intervention and prevention to engage
people at an earlier point when signs of a financial crisis might be emerging, empowering individuals to make
informed financial decisions and feel confident about managing their money, in a safe, inclusive and non-
judgmental environment.
• To provide safe, inclusive, culturally appropriate, timely and accessible financial counselling and
financial capability services to support people experiencing financial stress.
• To provide services that support the longer-term financial capability needs and build the confidence
and financial resilience of individuals, families and communities.
• Individuals, families and communities know where to go and how to access support if they are
experiencing financial difficulties or would like to build their financial capability skills.
• Individuals feel increased confidence to manage their money and are empowered to make informed
financial decisions.
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This grant round is being administered by the Community Grants Hub, on behalf of the Department of
Social Services.
Closing Date/Time
Please refer to the Closing Date/Time in the Grant Opportunity Guidelines
You will know that your application is saved when you are taken from the current application form page to
the ‘Form Saved’ page.
Note that the ‘Save and Close’ button will ask you to ‘Confirm’ that you wish to save the Application, which
you must do to complete the save process. If this is not done, your Application will not be saved.
You can return to your Application with the data saved using the link on the 'Form Saved' page that says
'Click here to return to your form' and confirming your submission reference ID details. Optionally, you can
access the saved form via the form open email received upon beginning the Application.
Note: Applicants will be notified of the grant funding outcome on completion of the assessment process.
Application Help
Information about the Application process is available on the GrantConnect and Community Grants Hub
websites.
Applicants may direct any general enquiries, question relating to the Program, the Application process, and
requests for technical help or support by contacting:
• Phone 1800020283
• Email to support@communitygrants.gov.au
Please note applicants may submit questions relating to the Program or Application Process up until five
Business Days prior to the Closing Time and Date. A response will be provided within five business days.
Attachment Limits
This Application Form allows users to attach files to support their application. You must provide an
attachment where mandatory. Use the 'Upload File' button to select your file.
Accepted file types: .bmp, .doc, .docx, .gif, .jpeg, .jpg, .msg, .pdf, .png, .pps, .ppt, .pptx, .txt, .xls, .xlsb,
.xlsx.
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Note: There is a 2mb limit per attachment. Multiple documents should be scanned into a single document.
Compressed or zip files are not accepted. File names must be unique using English language/characters
and MUST not include foreign characters.
Please note the form will no longer be accessible after two months of inactivity.
Once you have completed this Application Form, you must submit it electronically by using the submission
section at the end of this form.
Following electronic submission and completion of this Application Form, a message with your Submission
Reference ID will appear on your screen. An email will be sent to the primary contact provided in the
Application Form. A function is also available on the submission page to allow you to send a receipt email
to the address of your choosing. Please save this email receipt for future reference and use it in all
correspondence about this Application.
Please note: there may be short, scheduled outages to systems as part of regular information technology
maintenance that may affect submission of this form. Notification of these outages will be on the website.
• Payments made for grants to entities with an Australian Business Number (ABN)
• Payments made for services.
If you receive a payment from the Department that meets the ATO criteria, it will be reported to the ATO as
part of the Taxable payments annual report. Further information is available on the Australian Taxation
Office website.
Privacy
The Community Grants Hub uses an integrated Smartform service assisted by the Department of Industry,
Science and Resources on www.business.gov.au.
If you are providing information to access a non-Department of Industry, Science and Resources program,
that information will not be accessed by Department of Industry, Science and Resources employees. The
only exception to this is where Senior Analysts within the Department of Industry, Science and Resources
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require access to your information for the sole purpose of troubleshooting technical errors. Where this
occurs Senior Analysts will only access the data with permission and at the request of client agencies.
The Community Grants Hub will be able to access the Application as part of the form support services.
By submitting the Application you acknowledge that the information provided in the Application may be
shared with other Commonwealth and law enforcement agencies for the prevention and detection of fraud.
For more information about how the Department of Industry, Science and Resources’ Privacy Policy. The
Community Grants Hub Privacy Policy and WCaG Accessibility Information and the Department of Social
Services Privacy Policy should also be read and understood. The privacy statement in the relevant Grant
Opportunity Guidelines should also be read and understood.
Use of Information
Please send yourself a link to this saved form by entering your email address below. This email will detail
your Submission Reference, the date and time this application process will close, and a link to access your
saved form.
If you have any questions relating to this Application phone 1800020283 or email
support@communitygrants.gov.au.
Use of Information
The Community Grants Hub may use the information, other than personal information, provided in this
Application Form to assist it to:
• Comply with the Australian Government requirement to publish the details of all grant recipients on
the GrantConnect website
• Inform staff negotiating and establishing Grant Agreements of risks and issues that need to be
addressed in the Grant Agreement for that program
• Inform future assessments for Applications.
All information including personal information collected as part of this Application may be used by the
department or shared with other Commonwealth and law enforcement agencies for the purpose of
preventing and detecting fraud. This includes personal information of any third party provided in this
Application.
You can only apply if you agree to the use of the information you provide in this form for the purposes listed
above and that you have read and acknowledged the Hub Privacy Policy, the Privacy Statement, and all
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relevant material (including the Grant Opportunity Guidelines) as they relate to the collection and handling
of personal information.
☐ I agree*
☐ Yes ☐ No
If Yes, provide the Organisation ID number as it appears on your Grant Agreement and then click
'Verify ID' to confirm the details are correct.
Tip: Copy and paste the Organisation ID number from the Grant Agreement to avoid errors.
Organisation ID*
Postcode
Select ‘No’ if updates are not required to the Applicant’s details as currently held by the Community Grants
Hub.
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Select ‘Yes’ if updates are required to the Applicant’s details as currently held by the Community Grants
Hub. You will be required to contact your Funding Arrangement Manager to update your details.
☐ Yes ☐ No
☐ I confirm that I have contacted my Funding Arrangement Manager and my organisation information is
current. *
Eligibility Requirement
If you are unsure about the Applicant's entity type, please seek professional advice (e.g. from your lawyer
or accountant) or refer to the Community Grants Hub website for further information.
Please note if you are applying as a Trustee on behalf of a Trust you must select the Trustee's entity type.
Choose the entity type that is relevant to the Applicant from the list.
NOTE: There is a maximum of two attachments for this question if the response is Yes.
☐ Yes ☐ No
Organisation Type *
Is the Applicant an Indigenous organisation?
If YES, please select one definition below that best describes how your organisation is structured.
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If NO, please select 'Non-Indigenous organisation'.
Definitions:
☐ Non-Indigenous organisation
The National Redress Scheme for Institutional Child Sexual Abuse Grant Connected Policy makes non-
government institutions named in applications to the Scheme, or in the Royal Commission into Institutional
Responses to Child Sexual Abuse, that do not join the Scheme ineligible for future Australian Government
grant funding.
To be eligible for this Grant Opportunity you must respond to this question.
☐ I confirm
To be eligible for this Grant Opportunity you must respond to this question.
☐ I confirm
Note: If your proposed activity involves direct contact with children or contact with children is an
expected part of the activity, you are confirming the following measures will be in place before your
activity commences:
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• Child related employees, contractors or volunteers delivering the activity are compliant with all
State, Territory and Commonwealth law relating to the employment or engagement of people who
work or volunteer with children, including mandatory reporting and Working With Children Checks.
• National Principles for Child Safe Organisations are implemented.
• All Child-Related Personnel implement the National Principles for Child Safe Organisations.
• A risk assessment has been undertaken to identify the level of responsibility for Children and the
level of risk of harm or abuse to Children and appropriate risk management strategies to manage
any identified risks have been put in to place.
• A training and compliance regime is in place to ensure that all Child-Related Personnel are aware
of, and comply with:
o the National Principles for Child Safe Organisations;
o the Grantee's risk management strategy;
o Relevant Legislation relating to requirements for working with Children, including Working
With Children Checks; and
o Relevant Legislation relating to mandatory reporting of suspected child abuse or neglect,
however described.
• Any subcontracting arrangement entered into by the Grantee imposes the same obligations set out
here on the subcontractor and also requires the subcontractor to include those obligations in any
secondary subcontracts.
If your proposed activity falls under this category, and you are unable to confirm that the above
Child Safe measures will be in place before the activity commences, you may be ineligible for
funding. The delegate makes the final determination on eligibility.
Note: If your proposed activity involves irregular or unplanned contact with children, you are
confirming the following measures are in place before your activity commences:
• Child related employees, contractors or volunteers are compliant with all State, Territory and
Commonwealth law relating to the employment or engagement of people who work or volunteer
with children, including mandatory reporting and Working With Children Checks however described;
and
• Any subcontracting arrangement entered into by the Grantee, for the purposes of this grant
opportunity, imposes the obligations above on the subcontractor and also requires the
subcontractor to include those obligations in any secondary subcontracts.
If your proposed activity falls under this category, and you are unable to confirm that the above
Child Safe measures will be in place before the activity commences, you may be ineligible for
funding. The delegate makes the final determination on eligibility.
Confirmation
Governance
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Relevant Persons*
Has any senior official or person to be involved in delivering the Activity been involved in any of the
following events in the last 5 years?
You may be contacted to provide more information and documentation in relation to these events.
Position *
Description *
☐ Yes ☐ No
☐ Yes ☐ No
☐ Yes ☐ No
Project/Activity Details
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This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.
• The response should be easy to understand and written in plain English. Try not to use technical
terms, acronyms, or lingo.
• Your response should be a stand-alone summary of your project, or explain how you will implement
the services detailed in the Grant Opportunity Guidelines.
• The description may be used as part of our application review, and may be copied or published for
reporting or grant agreement purposes.
• The Service Area Type field below indicates the service areas relevant to this grant opportunity.
• If applicable, choose the relevant state/territory to view the available service areas.
• Tick the applicable service area/s where you are proposing to deliver this Project/Activity.
• Untick the selected service area/s to remove selection.
IMPORTANT NOTE:
You may only select 40 service areas per form. If you wish to apply for more services areas, a separate
form/s will need to be completed.
Outlet Locations *
Provide a list of the postcode(s) where your Financial Wellbeing Hub outlet(s) are proposed to be located
within each SA4 being applied for. Please ensure a comma is inserted between each postcode.
If you are unsure of postcodes for communities you will be providing services in, please check the Australia
Post - Find a postcode site.
If you are unable to provide the postcode of your Financial Wellbeing Hub outlet due to this not yet being
determined, please list 0000.
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This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @ $ %, other characters and formatting are not
accepted.
Financials
Total funding
Approx. % of Total
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Summary
2025-2026 total
2026-2027 total
2027-2028 total
2028-2029 total
2029-2030 total
Total funding
• BSB Number: Enter the BSB number for the Applicant’s nominated bank account. Must be 6 digits
only. Do not enter spaces or other characters.
• Account Number: Enter the account number for the Applicant’s nominated bank account. Must be 2
to 9 digits only. Do not enter spaces or other characters.
• Account Name: Enter the account name for the Applicant’s nominated bank account. The account
name should be as it appears on the bank statement. 60 character limit. The character count
includes letters, numbers, spaces, paragraph marks, bullet points etc.
NOTE: This field accepts the characters of A to Z, 0 to 9, ( ) , . ' & - / \ @, all other characters and formatting are not
accepted.
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Account Name*
Acceptable verification documentation is a recent bank statement, issued in the last 6 months, in a pdf file
type. The bank account must be in the name of the organisation applying for funding. The transaction
details and balances can be hidden but the BSB, Account Number and Account Name must be visible.
You may be contacted by the Community Grants Hub seeking additional information to support the
verification of your bank account details.
Assessment Criteria
• your organisation's track record, management approach, including the proposed governance
structure for administering the program in the target area, for example, normal or proposed
operations (including outlet location(s), hours of operation, delivery mechanisms (face-to-
face/online) proximity to transport, size, outreach services),
• the relevant capabilities (experience, skills and qualifications) of staff who are directly and indirectly
delivering Commonwealth Financial Counselling and Financial Capability services,
• development and training you will be providing to staff to ensure they have the necessary skills,
qualifications and support to deliver services to people accessing your services,
• how you will participate in sector wide projects, such as the National Debt Helpline Appointment
Booking system or similar projects that contribute to the capacity and capability building of the
financial counselling sector.
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• maintain or develop strong collaborative relationships with local support services to ensure people
can access additional support for non-financial matters. Other services may include family
relationship services, employment services, refugee services, family and domestic violence
services, mental health and housing programs.
• provide effective referral pathways internally and/or with local support services to address
underlying causes of financial stress (e.g. mental health, housing, substance abuse, gambling
issues).
• how you will report on these referrals including outcomes achieved through these referrals.
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Applicant Contacts
Title *
Telephone * Mobile*
Email address*
Title *
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Telephone * Mobile*
Email address*
Declaration
Describe any conflicts of interest that may occur from submitting this Application.
I declare that:
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• I consent to receive correspondence, legal notices, grant agreements and any subsequent letters of
variations to the agreement electronically. I understand and agree that my electronic
correspondences constitute a valid and legally binding method for interacting under the grant
agreement and the Electronic Transactions Act 1999 (Cth).
☐ I acknowledge that giving false or misleading information to the Community Grants Hub is a serious
offence under Section 137.1 of the Criminal Code Act 1995 (Cth). *
Program Feedback
How did you hear about the grant opportunity?*
Your response is limited to 750 characters including spaces and does not support formatting.
How satisfied were you with the process of applying for a grant?
Your response is limited to 750 characters including spaces and does not support formatting.
Please provide an estimate of the time taken to complete this Application Form, including:
• Actual time spent reading the guidelines, instructions and questions
• Time spent by all employees in collecting and providing the information
• Time spent completing all questions in the Application Form.
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Hours Minutes
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