Community Discretionary Fund Accountability Report

*- indicates required field.

This form must be used by clubs or organisations who applied for and received funding from either the Te Awamutu or Cambridge Community Boards or the Pirongia Ward Committee. This form provides feedback on how the funds were spent and the benefits gained. Failure to submit accountability requirements may jeopardise future funding applications made by your organisation.

Please select the board(s) or committee you received your financial assistance from: *

Te Awamutu Community Board (Te Awamutu/Kakepuku Wards – includes Kihikihi)

Cambridge Community Board (Cambridge/Maungatautari Wards – includes Karapiro)

Pirongia Ward Committee (includes Ohaupo, Kaipaki, Ngahinapouri, Te Pahu, Koromatua)

Name of club/organisation *

Amount of funding received *

Explain how the funding has been spent *

Give a brief description of the benefits that have been achieved with these funds *

Please include copies of receipts of payment *

Attach

(pdf, doc, txt or docx)

Please attach evidence of how you acknowledged the board committee support. (optional)

Attach

(pdf, doc, txt or docx)

Failure to submit accountability requirements may jeopardise future funding applications made by your organisation.

Contact Person

Contact name *

Position in organisation *

Daytime contact number *

Email address *

A copy of this form will be sent to this email address when submitted