rebecca watson - hamilton · if you would like context or background related to this lgoima...

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Rebecca Watson

From: official informationSent: Wednesday, 31 July 2019 13:01To:Cc: official information; Natalie PalmerSubject: RE: LGOIMA 19210: Pregnancy Counselling Services Attachments: LGOIMA 19210 - Pregnancy Counselling Services Applications.pdf

Kia ora, Further to your information request of 22 July 2019 in respect of Pregnancy Counselling Services, I am now able to provide Hamilton City Council’s response. You requested: Is there any chance you could send me through the applications for grants from Pregnancy Counselling Services? Our response: Please find attached all applications for grants from Pregnancy Counselling Services that Hamilton Council has received. Please note the names and contact information of private individuals involved with Pregnancy Counselling Services have been withheld under section 7(2)(a) of the Local Government Official Information and Meetings Act 1987 – in that release would infringe the privacy of natural persons.

If you have any concerns with the decision(s) referred to in this response, you have the right to request an investigation and review by the Ombudsman under section 27(3) of the Local Government Official Information and Meetings Act 1987. For your information, the Ombudsman’s contact details are:

Email: [email protected] Post: PO Box 10152, Wellington 6143 Telephone: 0800 802 602

If you would like context or background related to this LGOIMA response, or an interview with the subject matter expert, please contact the Communications Unit on 07 838 6699. Kind regards, Amy Viggers On behalf of the Privacy Officer DDI: 07 8386727 | Email: [email protected]

Hamilton City Council | Private Bag 3010 | Hamilton 3240 | www.hamilton.govt.nz

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This email and any attachments are strictly confidential and may contain privileged information. If you are not the intended recipient please delete the message and notify the sender. You should not read, copy, use, change, alter, disclose or deal in any manner whatsoever with this email or its attachments without written authorisation from the originating sender. Hamilton City Council does not accept any liability whatsoever in connection with this email and any attachments including in connection with computer viruses, data corruption, delay, interruption, unauthorised access or unauthorised amendment. Unless expressly stated to the contrary the content of this email, or any attachment, shall not be considered as creating any binding legal obligation upon Hamilton City Council. Any views expressed in this message are those of the individual sender and may not necessarily reflect the views of Hamilton City Council.

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From: Sent: Tuesday, 23 July 2019 11:28 AM To: official information <[email protected]> Cc: official information <[email protected]> Subject: Re: LGOIMA 19210: Pregnancy Counselling Services Hi Amy, All applications that you hold please. Kindest,

Journalist ‐ RNZ

From: official information <[email protected]> Sent: Tuesday, July 23, 2019 11:22:11 AM To: Cc: official information Subject: LGOIMA 19210: Pregnancy Counselling Services Kia ora, I refer to your official information request dated 22 July 2019 in respect of Pregnancy Counselling Services. We are seeking clarification as to the which applications for grants from Pregnancy Counselling Services you are requesting? Ie are you seeking the application applied for in 2018, the application applied for in 2017, both applications or all applications that we hold. Kind regards, Amy Viggers On behalf of the Privacy Officer DDI: 07 8386727 | Email: [email protected]




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From: official information Sent: Tuesday, 23 July 2019 9:31 AM To: Cc: official information <[email protected]> Subject: RE: LGOIMA 19210: Pregnancy Counselling Services Importance: High Kia ora, I write to acknowledge your information request of 22 July 2019 in respect of Pregnancy Counselling Services Please be advised that your request has been passed on to the relevant team within Council and you will be informed of the outcome. The Local Government Official Information and Meetings Act 1987 requires that we advise you of our decision on whether the Council will provide the requested information or not “as soon as reasonably practicable”, no later than 20 working days after the day we received your request. We will respond to you no later than 19 August 2019. Kind regards, Amy Viggers On behalf of the Privacy Officer DDI: 07 8386727 | Email: [email protected]




From: Jeff Neems Sent: Tuesday, 23 July 2019 8:57 AM To: Cc: official information <[email protected]> Subject: RE: Hamilton City Council grant to Pregnancy Counselling Services ‐ MEDIA EQUIRY Importance: High Hi , Direction from staff is we will need to treat this as a LGOIMA request – our email address for that is ccd. JN Jeff Neems Communication and Engagement Advisor Communication and Engagement Unit M: 021 818 564 L: 07 838 6509 E: [email protected]

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From: ] Sent: Monday, 22 July 2019 6:07 PM To: Jeff Neems <[email protected]> Subject: RE: Hamilton City Council grant to Pregnancy Counselling Services ‐ MEDIA EQUIRY Hey again Jeff, Is there any chance you could send me through the applications for grants from Pregnancy Counselling Services? Feel free to process this as a LGOIMA if necessary. Thanks,

From: Sent: Thursday, 18 July 2019 3:50 p.m. To: Jeff Neems <[email protected]> Subject: RE: Hamilton City Council grant to Pregnancy Counselling Services ‐ MEDIA EQUIRY Awesome. Thanks heaps for your help with this! I’ll let you know if I have any follow‐up questions. Cheers,

From: Jeff Neems <[email protected]> Sent: Thursday, 18 July 2019 3:40 p.m. To: > Cc: Sandra Larsen <[email protected]>; Andy Mannering <[email protected]> Subject: FW: Hamilton City Council grant to Pregnancy Counselling Services ‐ MEDIA EQUIRY Importance: High Kia ora , I have sought some advice from Sandra Larsen, our Community Funding Advisor. Sandra suggests there’s some confusion regarding the financial years being discussed here. The financial year on the document link below refers to the Council’s financial year (30 June) not the financial year of the group which is different (31 March) The grants were paid from the Council’s Single Year Community Grant rounds. Pregnancy Counselling Services received $2,600 + GST in 2016/17 (applied in Feb 2017; grant paid in May 2017) (shows in groups annual accounts to their year‐end 31/3/18 ‐ attached). $2,000 + GST in 2017/18 (applied in Feb 2018; paid in May 2018) (should show in groups annual accounts to their year‐end 31/3/2019). Jeff Neems Communication and Engagement Advisor Communication and Engagement Unit M: 021 818 564 L: 07 838 6509 E: [email protected]

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From: > Sent: Thursday, 18 July 2019 11:20 AM To: Natalie Palmer <[email protected]> Subject: Hamilton City Council grant to Pregnancy Counselling Services Hi Natalie, In the 2017/18 financial year, the council granted charity Pregnancy Counselling Services (PCS) $2600. I’m wondering if you could tell me what type of grant this was? I see this grant here, but the amount doesn’t match up: https://www.hamilton.govt.nz/our‐city/community‐development/useful‐info/communityfunding/Documents/Community%20Assistance%20Policy%20‐%20Single‐Year%20Community%20Grant%20(201718)%20‐%20Successful%20Applicants.pdf If it helps, their charities registration number is CC29761, their NZBN number is 9429042807681 and their postal address is PO Box 938, Waikato Mail Centre, Hamilton 3240 If you could come back to me by the end of tomorrow at the latest, that’d be great. Kind regards,

| Journalist – In Depth Radio New Zealand | Level 3 | 171 Hobson St PO Box 2209 | Auckland | New Zealand 1040

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Small Grants (Community) 2014Small Grants (Community) Application FormApplication SGC00040 From Pregnancy Counselling Services

Your organisation

* indicates a required field

Organisation details

Organisation Name * Pregnancy Counselling Services Please enter the registered (legal) name of your organisation.

Organisation Type * ☑ Charitable Trust ☐ Trust ☐ Other: ☐ RegisteredCharity

☐ IncorporatedSociety

Please select the relevant organisation type. If 'Other' pleasedescribe.

Charities RegistrationNumber

CC-29761 E.g. CC-12345

Purpose of Organisation*

To provide a confidential, 24 hour telephone help line forthose callers with pregnancy related issues and to assistwith practical help when needed.Must be no more than 25 words

Key Management Staff Area co-ordinator and committee. National Board. E.g. CEO, General Manager, Office Manager

Please estimate the number of people who benefit from the overall services delivered byyour Organisation.For Example: An Organisation delivering after school care programmes may benefit thefamilies that use the programmes as well as the wider community.

Number of People(Estimate)

1000 Must be a number

Please select theprimary purpose of theorganisation *

☐ Sports ☐ Community ☐ Education /Training

☐ Other:

☐ Environmental

☐ Health ☑ SocialService

Please select one choice only.

New Supplier Form

Please attach your completed New Supplier Form below.If you have not completed this yet please download and and complete a copy of the form:New Supplier Form

*Filename: hccgrantnewsupappform.pdfFile size: 186.5 kB

Page 1 of 7


Project Start Date * 01/07/2014 This must not be prior to 1 July 2015.

Project End Date * 30/06/2015 The date the project is completed.

Please select who willprimarily benefit fromthis project *

☑ YoungPeople

☐ Pacifika ☐ WiderCommunity

☐ Ethnic(PleaseSpecify in'Other' Below)

☐ TangataWhenua

☐ Children ☐ OlderPeople

☐ Other:

☐ People withDisability

☑ Families


Project Benefits to Community and/or EnvironmentPlease describe Who will benefit and How they will benefit.

* Women, babies and families will benefit from our servicesas well as the wider community. Our service is free,confidential and non-judgmental. We offer information,practical help in the way of baby clothes and equipment,referrals to other organisations and a listening ear.Sharing their thoughts and issues with a caring listenercan ease the anxiety an unplanned pregnancy cansometimes bring. When a young pregnant woman, whomay bring a boyfriend, mother or friend with her, meetswith two counsellors face to face, we find she often talksopenly about concerns that have not previously beenaired. Each client is different with different circumstances,beliefs and knowledge regarding pregnancy and thecounsellors work with the client for the best outcomefor the situation. The decision regarding the pregnancymust be made by the woman and we work to ensure sheis not coerced or pressured in any way if possible. Byproviding information we seek to help her be aware of thepossible consequences of her choice. An informed decisionis important for the well being of the client.Must be between 150 and 500 words

Please estimate the number of people who will benefit from this Project



Who is Involved in the Delivery of this Project?Please provide a paragraph for each of the key people delivering your Project, showing theirrelevant knowledge and experience.

Page 3 of 7


* The volunteer on telephone duty takes a call and respondsto the caller's needs. This may be answering questions,offering a free information booklet or referral ormakingarrangements for a face to face meeting.Two counsellors will meet a client face to face ifrequested. They will discuss any relevant issues andassess her needs. Referrals to other organisations may begiven.Our 26 counsellors receive initial training for telephoneinquiries and are gradually introduced to face to facecounselling partnering an experienced counsellor. Allvolunteers take part in monthly meetings where cases arediscussed. Ongoing training by professionals takes placeat annual Study Days and Conferences.Must be between 100 and 250 words

Financial information


Budget information

Is Your Organisation GSTRegistered? *

☑ Yes ☐ No

If 'Yes' please provideyour GST Number

89-619-203 Please enter your GST number.

If your Organisation is GST Registered DO NOT include GST in these costs

A. Total project costs

Expenditure Description Amount ($)

Baby clothes and equipment $500.00

Information (advertising, booklet postage, room hireage)

$500.00

Telephone $1,000.00

Total: $2,000.00

Please supply quotes to support your application where appropriate.PLEASE NOTE: This is an important part of your application.

Page 4 of 7


No files have been uploaded

B. Total project income

Income Description Amount ($)

Applications to other funders for this project

If funding has confirmed please ensure this amount has been entered into the incomesection of this application (see above).

Name of Funder Amount Requested Confirmed / Unconfimed

Total Cost of Project (A)*

$2,000.00 Must be a dollar amount

Total Income of Project(B)

Must be a dollar amount

Difference (A-B) Must be a dollar amount

Page 5 of 7


Amount requestedfrom Small Grant(Community)

$2,000.00 Amount requested must NOT exceed $5,000

Financial summary

Financial Accounts *Filename: HamiltonPCS2013BalanceSheet.pdfFile size: 10.7 kB

Filename: HamiltonPCS2013Inc&Exp.pdfFile size: 13.4 kBPlease attach your latest Audited Accounts.

Statement of FinancialPosition (no greaterthan 3 months old) *

Filename: HamiltonPCS2014FinancialPosition.pdfFile size: 11.2 kBMust show year to date income and expenditure.

Summary of CurrentBank Balance * Filename: PCSHamBankStatementFeb14.pdf

File size: 349.1 kBPlease attach a bank summary showing your current balance.

Bank Deposit Slip *Filename: PCSHamBankDepositSlip.pdfFile size: 70.4 kBPlease provide the bank deposit slip. NOTE: The account namemust be the same as the name of the organisation applying tothe grant.

Have you previouslyreceived funding fromHamilton City Council?

☑ Yes ☐ No

If "Yes" please provide the following information:

Name of Project Pregnancy Counselling Services

Date Delivered 03/02/2014 Must be a date

Did you providean AccountabilityReport for the fundingreceived?

☑ Yes ☐ No

Declaration


Page 6 of 7


In making this declaration I declare that:1. I am authorised to do so and to the best of my knowledge the information contained

herein is true and correct.2. Any Grant received will be used for the project for which it was approved.3. The organisation will comply with any reasonable request from Hamilton City Council to

monitor performance and accountability.

Full Name ofOrganisation *

Pregnancy Counselling Services

Full Name of AuthorisedSignatory *

Position of AuthorisedSignatory *

Funding officer

Date of Declaration * 20/03/2014

Page 7 of 7

Section 7(2)(a)

Small Grants (Community) 2015Small Grants (Community) Application FormApplication SGC-00055 From Pregnancy Counselling Services

Your organisation



Organisation Name * Pregnancy Counselling Services Please enter the registered (legal) name of your organisation.




Charities RegistrationNumber

CC-29761 E.g. CC-12345


To provide a confidential,24hour Telephone help line forthose callers with pregnancy related issues and to assistwith practical help when neededMust be no more than 25 words

Key Management Staff Area co-ordinator and committee, National Board. E.g. CEO, General Manager, Office Manager






☐ Other:

☐ Environmental



New Supplier Form

Please attach your completed New Supplier Form below.If you have not completed this yet please download and and complete a copy of the form:New Supplier Form

*Filename: New Supplier Application Form.pdfFile size: 818.8 kB

Page 1 of 7


Project Start Date * 01/07/2015 This must not be prior to 1 July 2015.


Please select who willprimarily benefit fromthis project *

☑ YoungPeople

☐ Pacifika ☐ WiderCommunity

☐ Ethnic(PleaseSpecify in'Other' Below)

☐ TangataWhenua

☐ Children ☐ OlderPeople

☐ Other:

☐ People withDisability

☑ Families



* Women, babies and families will benefit from our servicesas well as the wider community. Our service is free,confidential and non judgmental. We offer information,practical help in the way of baby clothes and equipment,referrals to other organisations and a listening ear.Sharing their thoughts and issues with a caring listenercan ease the anxiety an unplanned pregnancy cansometimes bring. When a young pregnant woman, whomay bring a boyfriend, mother or friend with her, meetswith two counsellors face to face, we find she often talksopenly about concerns that have not previously beenaired. Each client is different with different circumstances,beliefs and knowledge regarding pregnancy and thecounsellors work with the client for the best outcomefor the situation. The decision regarding the pregnancymust be made by the woman and we work to ensure sheis not coerced or pressured in any way if possible. Byproviding information we seek to help her be aware of thepossible consequences of her choice. An informed decisionis important for the wellbeing of the client.Must be between 150 and 500 words





Page 3 of 7


* The Volunteer on telephone duty takes a call and respondsto the callers needs. This maybe answering questions,offering a free information booklet or referral or makingarrangements for a face to face meeting.Two Counsellors will meet a client face to face ifrequested. They will discuss any relevant issues andassess her need. Referrals to other organisations may begiven.Our 26 Counsellors receive initial training for telephoneinquiries and are gradually introduced to face to facecounselling partnering an experienced counsellor. Allvolunteers take part in monthly meetings where cases arediscussed. Ongoing training by professionals takes placeat annual Study Days and Conferences.Must be between 100 and 250 words



Budget information


☑ Yes ☐ No


89619203 Please enter your GST number.



Expenditure Description Amount ($)

Baby clothes and equipment $500.00

Information (advertising, booklet postage, room hireage)

$1,000.00

Telephone $1,500.00

Total: $3,000.00


Page 4 of 7




Income Description Amount ($)


If funding has confirmed please ensure this amount has been entered into the incomesection of this application (see above).







Page 5 of 7


Amount requestedfrom Small Grant(Community)


Financial summary

Financial Accounts *Filename: PCSHamilton2014report.pdfFile size: 488.0 kBPlease attach your latest Audited Accounts.


Filename: Statement_of_Financial_31-1-15.jpgFile size: 52.1 kBMust show year to date income and expenditure.

Summary of CurrentBank Balance * Filename: Statement_of_Financial_31-1-15-Pg2.jpg



Have you previouslyreceived funding fromHamilton City Council?

☑ Yes ☐ No


Name of Project Baby clothing & equipment, telephone, information support



☑ Yes ☐ No

Declaration


In making this declaration I declare that:

Page 6 of 7


1. I am authorised to do so and to the best of my knowledge the information containedherein is true and correct.

2. Any Grant received will be used for the project for which it was approved.3. The organisation will comply with any reasonable request from Hamilton City Council to






Funding Officer


Page 7 of 7

Section 7(2)(a)

2016 Single-Year Community GrantSingle-Year Community Grant 2016Application SYG-064-2016 From Pregnancy Counselling Services

Your organisation



Organisation Name * Pregnancy Counselling Service Please enter the registered (legal) name of your organisation.




Charities RegistrationNumber *

CC-29761 E.g. CC-12345


We provide a 24hr confidential phone help line to womenwho have questions about pregnancy, adoption, orabortion and who may be distressed, anxious, in needof information or have physical needs that we providepractical assistance.Must be no more than 50 words



☐ Other:

☐ Environmental



Key Management Staff Area Co-ordinator and Committee, National Board. E.g. Jane Doe - CEO, Sam Smith - General Manager




How long has yourorganisation been inoperation?

31 E.g. Four years, nine months

Physical Address * ,

Page 1 of 7

Section 7(2)(a)


Temple View Hamilton 3218 New Zealand Must be a New Zealand post code

Postal Address * P.O. Box 1178 Hamilton Hamilton 3210 New Zealand Must be a New Zealand post code

Contact Person *y Contact for this application.

Position * Funding Officer Please enter the position of the Primary Contact given above.

Contact Phone Number * ter the contact phone number for the Primary Contact

given above.

Contact Email Address * [email protected] Please enter the email address for the Primary Contact givenabove.

Your Project


Project details

Hamilton City Council Single-Year Community Grant supports not-for-profit communityorganisations that support small community led projects that contribute to the socialwellbeing of the city by delivering community wide services.Single-Year Community Grants will fund organisations for:

• Operating and administrative costs• Equipment and resources that support the project or organisation• Programme development and implementation

Project Name Pregnancy assistance,Telephone, Advertising & Training.

Project Description * TELEPHONE & ADVERTISING:To provide a free, 24hr phone service and a confidentialsetting for face to face meetings with volunteercounsellors. To supply baby clothes and equipment topregnant women in financial difficulties and to provideinformation [pamphlets & booklets} to help our clientsmake an inform choice regarding their pregnancy.TRAINING:For our Counsellors to assist in gaining the rightinformation, where to refer clients to if necessary, whatservices are available for her best interest, her comfort,her peace of mind & her health. To assist our clients

Page 2 of 7

Section 7(2)(a)

Section 7(2)(a)


with the best possible outcome, regular training for ourcounsellors is a must. We have a Training Weekendplanned for October with a guest speaker coming fromChristchurch. We would appreciate funding to help withthis Training. The guest speaker is renowned CarolinaGnad who can be seen on www.dawnings.co.nz/about/index.aspMust be no more than 1000 words

Project Start Date * 01/07/2016


Who will primarilybenefit from thisProject? *

☑ Young People ☐ People withDisability

☐ Other: families

☐ Older People ☐ WiderCommunity

Please select one option

Which Ethnic group willprimarily benefit fromthe Project? *

☐ Maaori ☐ Indian ☐ European☐ Pasifika ☐ MELAA (Middle

Eastern, LatinAmerican, Africa)

☑ Other: Everyonewho callsregardless ofnationaity.

☐ Chinese Please select one option


* Women, babies, families and the wider communitywill benefit from our services. It is a free, confidentialand non judgmental service. We offer information,referrals to other organisations as needed, a listening ear,and practical assistance in the form of baby clothes &equipment. Sharing thoughts and concerns with a caringlistener can ease the anxiety of an unplanned pregnancy.A young pregnant woman who may bring a boyfriend,mother or friend to meet with two counsellors faceto face, we find she often talks openly about herconcerns that may not have been previously aired.Each client is different with individual circumstances,beliefs, knowledge, religion, etc regarding pregnancy.Counsellors can work with the client for the best outcomefor her situation. The decision regarding the pregnancymust always be made by the woman & we work toensure she is not coerced or pressured in any way byproviding information. We seek to help her be awareall consequences of her choice. An informed decision isimportant for the wellbeing of the client.

Page 3 of 7


Must be no more than 500 words





* The volunteer on telephone duty takes a call andresponds to the callers needs. This can be answeringquestions, offering a free information booklet or makingarrangements for a face to face meeting.Two counsellors will meet a client face to face ifrequested. They will discuss any relevant issues andassess her needs. Referrals to other organisations may begiven.Our 20 counsellors receive initial training for telephoneinquires and are gradually introduced to face to facecounselling, partnering an experienced counsellor. Allvolunteers take part in a monthly training meeting whereanonymous cases are discussed. On going training byprofessionals takes place at annual Study Days, TrainingWeekends and Conferences. This coming (October)Conference we have invited a highly skilled trainer fromChristchurch to speak to our counsellors



Budget information


☑ Yes ☐ No





Page 4 of 7


Expenditure Description (include andspecify any in-kind expenditure)

Amount ($)

Baby clothes & equipment $500.00

Telephone $1,000.00

Information [ advertising, room hireage ] $500.00

Training $1,500.00

Total: $3,500.00




Income Description (include and specifyany in-kind income)

Amount ($)

We work within the budget we receive


If funding has been confirmed please ensure this amount has been entered into the incomesection of this application (see Table A above).


Page 5 of 7







Amount requested fromSingle-Year CommunityGrant


Financial summary

Financial Accounts *Filename: HamiltonPCS2016Feb29IncomeExpense.pdfFile size: 11.6 kBPlease attach your latest annual accounts.


Filename: HamiltonPCS2016Feb29BalanceSheet.pdfFile size: 11.0 kBMust show year to date income and expenditure.

Summary of CurrentBank Balance * Filename: PCSBankstatementsMar2016.pdf



Have you previouslyreceived funding fromHamilton City Council? *

☑ Yes ☐ No


Page 6 of 7


Name of Project Pregnancy Help & Training

Most recent Grant wasreceived from whichfund

Small If 'Other' please specify



☑ Yes ☐ No

New Supplier Form

If you weren't a recipient of a Hamilton City Council Small Grant 2015 or your details havesince changed please complete and attach a New Supplier Form below.Download and complete a copy of the form here: New Supplier Form


Declaration









Funding Officer


Page 7 of 7

Section 7(2)(a)

2017 Single-Year Community Grant2017 Single-Year Community GrantApplication SYC-034-2017 From Pregnancy Counselling Services

◉ Yes ◯ NoNOTE: Your organisation must be registered with Charities Services to apply to this fund. If yourorganisation is NOT registered then please tick NO, and see page 4 of this application on UmbrellaApplications.

Charities Services Registration number *CC-29761 If Yes, please enter your registration number

Aim of your organisation *To provide a confidential, 24-hour Telephone help line for those callers with pregnancyrelated issues and to assist with practical help when needed.Mission Statement. Must be no more than 50 words

Please select the primary sector of your organisation *☐ Arts / Culture ☑ Social Service ☐ Education / Training ☐ Sports☐ Environmental ☐ Health ☐ Community ☐ Other: Please select one choice only.

What programmes or services does your organisation provide? *Phone counsellingFace to face counsellingPractical help by providing baby clothes and equipmentLinking clients with other organizationsPlease list. Must be no more than 100 words

Number of people (Estimate) *1100 Please provide a realistic estimate of the number of individual people who benefit each year from allthe services delivered by your organisation. For example if one person attends five times throughoutthe year they are counted as one person.

Your Project


Project Details:

Hamilton City Council Single-Year Community Grant supports not-for-profit communityorganisations that support small community led projects that contribute to the socialwellbeing of the city by delivering community wide services.Single-Year Community Grants will fund organisations for:

• Operating and administrative costs• Programme or service development and implementation• Events and cultural celebrations• Equipment and resources that support the project or organisation

Project name * Goods for clients, Advertising, Phone expense, Professional Development

Page 2 of 9


Which Ethnic group willprimarily benefit fromthe project? *

☐ Maaori ☐ European ☐ Latin American☐ Pasifika ☐ Middle East ☐ Africa☐ Chinese ☐ Indian ☑ Other: all ethnic

groupsPlease select one option

Please describe howpeople and the widercommunity/ environmentwill benefit from thisproject. *

The wider community will benefit from this project byindividuals and families receiving support in a time ofcrisis. Studies have shown that women who feel pressuredinto having an abortion are more likely to have mentalhealth problems in later life. It can also affect the way theyinteract with their children and other family members.No more than 500 words

How will you measure the success of this project?

* More confident and motivated counsellors after theconference resulting in clients who are able to makeinformed decisions. If the clients are satisfied with theirdecision, the more likely they are to feel good about itlong term.No more than 100 words

Additional Information:

Please feel free to add any additional comments or information relevant to thisapplication.Please add any comments. Must be no more than 500 words.




Financial Information


PLEASE NOTE: This is an important part of your application.

Is your organisation GSTregistered? *

☑ Yes ☐ No

Page 4 of 9


If 'Yes' please provideyour GST number


Project Budget:

If your organisation is GST registered DO NOT include GST in these costs


Please provide details of what your project is going to cost eg: venue hire, equipment costsetc


Amount ($)

Baby Clothes and Equipment $500.00

Telephone Expense $500.00

Advertising $1,400.00

Flights to Dunedin $3,130.00

Professional Development Conference $1,200.00

Total: $6,730.00Must be a dollar amount.

Please supply quotes to support your application where appropriate.

Filename: House of Travel quote.pdfFile size: 147.7 kB

Filename: STA quote 1.pdfFile size: 224.9 kB

Filename: STA quote 2.pdfFile size: 206.5 kB


Please provide details of any income you may be expecting to help pay for the costs of theproject eg: entry fees, donations, confirmed grants from other funders etc.


Amount ($)

Grant from COGS - South Waikato $1,000.00

Fundraising by counsellors $1,000.00

Page 5 of 9


Counsellor contribution to conference $600.00

Total: $2,600.00Must be dollar amount


If you have applied to other funders for this project please list here. If funding has beenconfirmed please ensure this amount has been entered into the income section of thisapplication (see Table B above).


Total cost of project (A)*

$6,730.00 What is the total cost (dollars) of your project?

Total income of project(B) *

$2,600.00 What is the total income (dollars) towards your project?

Difference (A-B) * $4,130.00 Total cost (A) - total income (B) = balance required. Must be adollar amount

Amount requested fromSingle-Year CommunityGrant *

$4,000.00 Amount requested must be no more than $5,000.

Financial summary of your organisation:

Total annual income * 9237 Please enter your total annual income of your organisation asshown on your annual accounts.

Page 6 of 9


Financial accounts *Filename: PCS Performance Report 31 Mar 2016.pdfFile size: 5.5 MBPlease attach your latest annual accounts.


Filename: HamiltonPCS Balance Sheet 28Feb2017.pdfFile size: 19.1 kB

Filename: HamiltonPCS Income&Expense 28Feb2017.pdfFile size: 21.7 kBMust show year to date income and expenditure.

Total bank balance * $16006 Please add together all the balances from all your bank accountsand enter the total here.

Summary BankStatement * Filename: PCS Bank Statement 28Feb2017.pdf

File size: 677.9 kBPlease attach a summary list of your bank accounts showing yourcurrent balances.

Tagged funds Phone Expense 700Baby Clothes 700Travel expense for counsellors 1700Advertising 500Total $3600If the funds in your bank account are set aside for a project,please tell us the project name and the amount that is allocatedtowards it eg: Building development costs $50,000

Previous funding:

Have you previously received funding from Hamilton City Council? *☑ Yes ☐ No


Your most recent Grant was received from which fund?Single-Year Grant If 'Other' please specify

Name of projectPregnancy assistance,Telephone, Advertising & Training

Amount received$2875

Date delivered24/02/1917 Must be a date

Page 7 of 9


Did you provide an Accountability Report for the funding received?☑ Yes ☐ No

Umbrella Application

First time applicant or change of bank details

New Supplier Form

If you weren't a recipient of a Hamilton City Council 2016 Single-Year Grant or your detailshave since changed please complete and attach a New Supplier Form below.If your application is being umbrelled by another organisation, please attach their depositslip here if they have not previously received funding from Hamilton City Council or theirbank account details have changed.Download and complete a copy of the form here: New Supplier Form

Bank Deposit Slip No files have been uploadedPlease provide the bank deposit slip if you are a first timeapplicant or have changed your bank account. NOTE: Theaccount name must be the same as the name of the organisationapplying for the grant, or in the name of the umbrellaorganisation.


Declaration




monitor performance and accountability.4. I have read and understood the Community Assistance Policy and assoicated

guidelines. 1.CommunityAssistance Policy 2.Community Assistance Funding process


Pregnancy Counselling Services - Hamilton


Page 8 of 9

Section 7(2)(a)



Funding Officer


Page 9 of 9



Project Details:

Hamilton City Council’s Single-Year Community Grants support not-for-profit communityorganisations that deliver services, programmes and activities that benefit the social,cultural, arts and environmental well-being of communities in Hamilton.Funding consideration will be given to community organisations which:

• Strengthen participation across diverse communities• Build the capability of communities to become sustainable• Work collaboratively across the community sectors.

Single-year grants will fund organisations for:• Operating and administrative costs.• Programme development and implementation.• Equipment and resources that support the project or organisation.

Project name * Pregnancy Help & Awareness

Project description * We are seeking funds to keep our phone lines open24 hours a day. We need funds to assist with trainingnew counsellors so that all time slots can be filled. Ourpotential clients need to be aware of our service and weare seeking funds to advertise the service on Facebookand other forms of media. Some of our clients need a fewbaby items to help them when their circumstances arelimited.No more than 500 words

Please select the typeof project that best fitsyour request. *

☑ Operating / AdministrationCosts

☐ Programme developmentand implementation

☐ Equipment / ResourceCosts

Project start date The date the project starts.

Project end date The date the project is completed.

Ongoing ◉ OngoingPlease tick if your project is ongoing eg; operating costs

Who is involved in thedelivery of this project?Please provide thenames of key peopledelivering your project,showing their role andrelevant knowledge andexperience. *

We have three ladies involved in training new counsellors.They are They have been operating in these roles for about 4 yearsand have prepared and delivered training sessions twice ayear. is the treasurer and she overseesthe advertising of the service. She has been in this roleover 10 years. also organises the parcels of babyclothes to go the new mums in need.

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All counsellors are trained for their role by the trainersand all counsellors receive ongoing training at monthlymeetings and special training days which are heldannually.

Project Benefits:

Who will primarilybenefit from thisproject? *

☐ Young People ☐ People withDisability

☐ Other:

☐ Older People ☑ WiderCommunity

Please select one main option

Which Ethnic group willprimarily benefit fromthe project? *

☐ Maaori ☐ NZ European ☐ Latin American☐ Pasifika ☐ Middle East ☐ Africa☐ Chinese ☐ Indian ☑ Other: all are

welcomePlease select one main option

Please describe howpeople and the widercommunity/ environmentwill benefit from thisproject. *

Our aim is to help mothers and potential mothers makean informed decision regarding their pregnancy. Oftenpartners, parents and friends come to face to facecounselling sessions with a young woman. We offerinformation, referrals to other organisations as needed,a listening ear, and practical assistance in the form ofbaby clothes and equipment. Sharing thoughts andconcerns with a caring listener can ease the anxiety ofan unplanned pregnancy. We seek to help the client beaware of the options she has so an informed decision canbe made. This is good for the client and her family and thecommunity.No more than 500 words

How will you measurethe success of thisproject? *

All counsellors record the calls received and face to facemeetings. We also note the feedback we receive fromclients. We know that numbers do not tell the whole story.If we can positively help someone that may influence awhole family and the wider whanau.


Please feel free to add any additional comments or information relevant to thisapplication.Our Funding officer is away so , treasurer has completed theapplication. Recent feedback from clients:- Thank you so much for listening to me. Youhave given me some great ideas to think about. I should have had counselling after myother terminations and I will definitely call your service again. - My friend's daughter had amiscarriage and was very upset about it. She called PCS and was a different person whenshe got off the phone. The counsellor has helped her tremendously.Must be no more than 500 words.

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Other relevant attachments:No files have been uploaded



PLEASE NOTE: This is an important part of your application.


☑ Yes ☐ No



Project Budget:

If your organisation is GST registered DO NOT include GST in these costs


Please provide details of what your project is going to cost eg: venue hire, equipment costsetc


Amount ($)

Advertising - Facebook and other media $2,500.00

Baby clothes and equipment $1,000.00

Phone Expense $1,000.00

Training - room hire and reimbursement of mileage

$500.00

Total: $5,000.00Must be a dollar amount.

Please supply quotes to support your application where appropriate.

Quotes No files have been uploaded


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Please provide details of any income you may be expecting to help pay for the costs of theproject eg: entry fees, donations, confirmed grants from other funders etc.


Amount ($)

Baby quilts and knitting are regularly donated

$200.00

Total: $200.00Must be dollar amount


If you have submitted any applications for this project which are currently pending withother funders or intend to make applications to other funders please provide the detailshere.

Name of Funder Amount Requested

Catholic Care Foundation $2,000.00

Total: $2,000.00




$200.00 What is the total income (dollars) towards your project?

Difference (A-B) * $4,800.00 Total cost (A) - total income (B) = balance required. If this figureis more than your request please complete budget shortfallquestion below.

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Amount requestedfrom this Single-YearCommunity Grant *

$3,000.00 Requested limit $8,000.

Budget shortfall. If thefigure in the box abovemarked 'Difference (A-B)' is more than yourrequest please tell ushow you plan to fund theshortfall?

We work with the money we receive and will cut some ofthe advertising if there is a shortfall.



Financial accounts *Filename: PCS Hamilton 2017 Financial report.pdfFile size: 1.4 MB

Filename: Pregnancy Counselling Services Nonfinancial report 2017 Hamilton.pdfFile size: 462.6 kBPlease attach your latest annual accounts.


Filename: PCS Hamilton Financial Position 31Jan18.pdfFile size: 788.6 kBMust show year to date income and expenditure.

Total bank balance * $16078 Please add together all the balances from all your bank accountsand enter the total here.

Summary BankStatement * Filename: PCS Hamilton Bank Summary 31 Jan 2018.pdf

File size: 405.9 kBPlease attach a summary list of your bank accounts showing yourcurrent balances.

Tagged funds Grants not yet spent:COGS - Kirikiriroa 390COGS - South Waikato 1000Total $1390Tagged funds:Phone expense 1500Training 600Counsellor reimbursements 600Total $3900

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If the funds in your bank account are set aside for a project,please tell us the project name and the amount that is allocatedtowards it eg: Building development costs $50,000

Previous funding:

Have you previously received funding from Hamilton City Council? *☑ Yes ☐ No


Your most recent Grant was received from which fund?Single-Year Grant If 'Other' please specify

Name of projectPregnancy Help & Training

Amount received$2600

Date delivered20/06/2017 Must be a date

Did you provide an Accountability Report for the funding received?☑ Yes ☐ No

Declaration


In making this declaration I declare that:1. I am authorised to do so and to the best of my knowledge, the information contained

herein is true and correct.2. I have read and understood the Community Assistance Policy and associated

guidelines. Community Assistance Policy and Process3. Hamilton City Council will advise our organisation of the outcome of this application.

If successful, an authorised person from this organisation will complete a GrantAgreement Form and upload an invoice for payment through SmartyGrants.

4. Any grant received will be used for the project for which it was approved. Once fundshave been spent this organisation will complete the required accountability form.

5. The organisation will comply with any reasonable request from Hamilton City Council tomonitor performance and accountability.


Pregnancy Counselling Services - Hamilton Branch

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Treasurer


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Section 7(2)(a)

2019 Single Year Community Grant2019 Single-Year Community GrantApplication SYC-121-2019 From Pregnancy Counselling Services

Your organisation


Organisation Name and Contact:

Organisation name * Pregnancy Counselling Services - Hamilton Branch Please enter the registered (legal) name of your organisation.

Physical address * 169 London St Hamilton Central Hamilton 3204 Must be a New Zealand post code.

Contact person *of the primary contact person for this

application.

Position * Treasurer Please enter the position of the primary contact given above.

Contact phone number * Please enter the contact phone number for the primary contactgiven above.

Contact email address * Please enter the email address for the primary contact givenabove.

Who are your keymanagement staff? *

- Co-ordinator, - Secretary oe - CEO, Sam Smi hn Barlow - Event

Organiser

Key Office Holder * one number of your

organisation's Chairperson, Secretary or Treasurer.

Does your organisationhave a minimum of 4people on the committeeor governance group? *

☑ Yes☐ NoIf No, please contact HCC Funding Advisor (07) 838 6630 beforecompleting the rest of the form.

How many paid staff doyou have? *

0

How many volunteers doyou have? *

16

Is your organisationregistered with CharitiesServices? *

◉ Yes ◯ No

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2018

Did you provide an Accountability Report for the funding received?☑ Yes ☐ No Please note, not submitting accountability may exclude you from receiving any further grants. Pleasecheck with our Funding Advisor if you are not sure, phone 838 6630

Your Project


Project Details:

Please note this Single Year Community Grants round closes at 5pm on 1st March2019.Hamilton City Council’s Single-Year Community Grants support not-for-profit communityorganisations that deliver services, programmes and activities that benefit the social,cultural, arts and environmental well-being of communities in Hamilton.Funding consideration will be given to community organisations which:

• Strengthen participation across diverse communities• Build the capability of communities to become sustainable• Work collaboratively across the community sectors.

Single-year grants will fund organisations for:• Operating and administrative costs.• Programme development and implementation.• Equipment and resources that support the project or organisation.

Project name * Pregnancy Help & Awareness

Project description * We are seeking funds to keep our phone lines open 24hours a day. We need funds to assist with training newand current counsellors so that we can offer this serviceeffectively. A national training day will be held in Mosgielthis year and we need assistance with travel costs. Ourpotential clients need to be aware of our service and weare seeking funds to advertise the service on Facebookand other forms of media. Some of our clients need a fewbaby items to help them when their circumstances arelimited.No more than 200 words

Please select the typeof project that best fitsyour request. *

Operating / Administration Costs

Please select whichfunding priority best fitsyour project *

Work collaboratively across the community sectors.

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Please describehow people and thewider community orenvironment will benefitfrom this project. *

Our aim is to help mothers and potential mothers makean informed decision regarding their pregnancy. Oftenpartners, parents and friends come to face to facecounselling sessions with a young woman. We offerinformation, referrals to other organisations as needed,a listening ear, and practical assistance in the form ofbaby clothes and equipment. Sharing thoughts andconcerns with a caring listener can ease the anxiety ofan unplanned pregnancy. We seek to help the client beaware of the options she has so an informed decision canbe made. This is good for the client, her family and thecommunity. Our volunteers gain further development asthey attend training sessions to help them be the bestthey can be for their clients.No more than 300 words

How will you measurethe success of thisproject? *

All counsellors record the calls received, face to facemeetings and baby clothes given out. We also note thefeedback we receive from clients. We know that numbersdo not tell the whole story. If we can help someone theirdecision may positively influence a whole family andthe wider whanau. We also require feedback from thecounsellors who attend the training sessions.No more than 200 words


Please feel free to add any additional comments or information relevant to thisapplication.No more than 500 words.

Other relevant attachments:No files have been uploaded



GST


☑ Yes ☐ No



Project Budget (compulsory)

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A project budget is essential. If your organisation is GST registered DO NOT includeGST in these costs. Please attach the budget for your project below. If you are applying foroperating costs please attach your whole annual operating budget. You can either attachyour own budget or if you don't have one, use the budget template below.1) To view an example of a budget click this link Example Budget2) To access a template for a budget click this link Budget Template You will need to savethe template to you computer, fill it out and then upload it to this application form using thebutton below.If you have any queries regarding this budget section - please call our Funding Advisorph 838 6630

Project Budget *Filename: HamiltonPCSBudget 2019.pdfFile size: 12.0 kBPlease attach your project budget here

Quotes

Please attach quotes below only if it is applicable to your project eg: purchase ofequipment or small capital projects.Quotes for general operating costs are not required.

QuotesNo files have been uploadedPlease attach any relevant quotes here

Do you have other applications pending for this project?

Planning the funding for your project is important. It shows us how you intend to meet thetotal costs of your project. Please tell us if you are waiting on the outcome of other fundingapplications you have made, or intend to make, to other funders for this project? DO NOTINCLUDE funding that has already been confirmed (this should be shown as income inyour attached budget).

☑ Yes☐ NoTick yes if you intend to make other applications or are waiting for a reply to an application you havemade to another funder for this project.


If yes, please tell us who you have applied to or intend to apply to help support the costs ofthis project.

Name of Funder Amount Requested

Common Good $2,000.00

COGS Kirkiriroa $4,000.00

COGS South Waikato $4,000.00

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Total: $10,000.00




$17,470.00 What is the total income (dollars) towards your project?

Difference (A-B) * $0.00 Total cost (A) - total income (B) = balance required. If this figureis more than your request please complete budget shortfallquestion below.

Amount requestedfrom this Single-YearCommunity Grant($8,000 limit) *

$5,400.00 Requested limit is $8,000.

Budget shortfall. If thenumber in the box abovemarked 'Difference (A-B)' is more than you arerequesting please tell ushow you plan to fund theshortfall?

For example if the number in box 'Difference (A-B)'' is $10,000and you are requesting $8,000, tell us how you will fund the$2,000 shortfall



Annual FinancialStatements * Filename: HamiltonPCSReports31Mar2018.pdf

File size: 3.9 MBPlease attach your latest annual financial statements eg: Incomeand Expense, Balance Sheet etc.

Statement of FinancialPerformance (no greaterthan 3 months old) *

Filename: HamiltonPCSFinancial Position 31Dec2018.pdfFile size: 11.2 kB

Filename: HamiltonPCSIncome & Exp 31Dec2018.pdfFile size: 13.7 kBMust show year to date income and expenditure.

Total bank balance * $14568.11

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Please add together all the balances from all your bank accounts,including any term deposits, and enter the total here.

Summary BankStatement * Filename: PCS Bank Summary 31Jan2019.pdf

File size: 420.3 kBPlease attach a summary list of your bank accounts showing yourcurrent balances, including term deposits.

Tagged funds Phone expense $800Training $200Counsellor reimbursements $500Baby Clothes $307Room Hire $135Advertising $120GST $611Total $2673If the funds in your bank account are set aside for a project,please tell us the project name and the amount that is allocatedtowards it eg: Building development costs $50,000

Declaration


In making this declaration I declare that:1. I am authorised to do so and to the best of my knowledge, the information contained

herein is true and correct.2. I have read and understood the Community Assistance Policy and associated

guidelines.3. I verify that our organisation is fully compliant with all applicable legislation, including

the requirements under the Vulnerable Children Act 2014 to safety check yourvolunteers and staff (if applicable).

4. I verify that our organisation has two bank signatories, maintains good record keepingsystems (including finance) and presents reports regularly to governing body meetings.

5. Hamilton City Council will advise our organisation of the outcome of this application.If successful, an authorised person from this organisation will complete a GrantAgreement Form and upload an invoice for payment through SmartyGrants.

6. Any grant received will be used for the project for which it was approved. Once fundshave been spent this organisation will complete the required accountability form.

7. The organisation will comply with any reasonable request from Hamilton City Council tomonitor performance and accountability.


Pregnancy Counselling Services - Hamilton Branch


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Treasurer


Your Feedback

We value your feedback to help us improve our funding process. We would appreciate youtaking another couple of minutes to complete this section.

How easy was the application form to complete?Hard

How many hours did it take you to complete this application?3-5 hrs

Please add any other comments you may have about how we can improve ourfunding process.

Thank you for taking the time to complete this feedback section.

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