SPONSORSHIP & DONATIONS APPLICATION Port Waratah’s goal is to create shared value for our stakeholders and seeks to have a positive impact by working in partnership to make Newcastle a smart, liveable and sustainable city.

The objectives are to support a range of different initiatives, projects and programmes which;

1. Deliver value back to the Newcastle community, particularly port side suburbs;2. Address a specific are of need or opportunity within the community to contribute to

the overall sustainability of the region;3. Delivers benefit to many people; and4. Builds capacity, skills and/or knowledge within organisation that last beyond the

funding.

Priority Areas

Diversity; Economic; Education; Environment; General Community; and Health.

Exclusions

Individuals, including students; Activities viewed as the responsibility of government; Programmes with a political or religious purpose; Organisations established for private gain or benefit; Overseas appeals or projects; Travel, study or conferences; Scholarships; Sporting clubs/teams without clear secondary benefit aligned with Port Waratah’s

priority areas and objectives; Programmes or activities based outside the Newcastle LGA; Activities/projects that will have ongoing reliance on Port Waratah support for

survival.

How to Apply

Please complete this Community Investment Funding Application and submit to:

Port Waratah Coal ServicesSponsorships & Donations

PO Box 57 CARRINGTON. NSW 2294Email: communitypartnerships@pwcs.com.au

Which Priority Area and Location best fit your project?

Priority Area(please choose one)

Location(please choose one)

Diversity ☐Economic ☐Education ☐Environment ☐General Community ☐Health ☐

Carrington ☐Hunter Region ☐Mayfield ☐Newcastle Region ☐Stockton/Fern Bay ☐Throsby Villages ☐

Organisation

Registered Name: Click here to enter text.ACN/ABN: Click here to enter text.Postal Address: Click here to enter text.Street Address: Click here to enter text.Primary Contact: Name: Click here to enter text.

Phone: Click here to enter text.Email: Click here to enter text.

Status:(eg. Registered Charity, Not for Profit, ACNC Register)

Click here to enter text.

Organisation Description;(aims and objectives)

Click here to enter text.

Has your organisation approach/received funding/support from Port Waratah previously?

Yes ☐No ☐

If yes, please provide details(project and funding amount)

Click here to enter text.

Project

Name of Project: Click here to enter text.Project Description:(aims and objectives)

Click here to enter text.

Is this project? New ☐Ongoing ☐

Project location: Click here to enter text.Is the project longer term?(1+ years)

Yes ☐No ☐

Funding

What is the value of funding requested from Port Waratah?

$ Click here to enter text.

What is the total cost of the project? $ Click here to enter text.What percentage of the total project budget will Port Waratah contribute?

%

Are there other sources of funding that the project is dependent upon? Yes ☐No ☐

If yes, please provide details

Click here to enter text.

Assessment Criteria

How does the project address an area of need?Click here to enter text.How does this project contribute to a sustainable and vibrant Newcastle?Click here to enter text.Is it intended the project will continue beyond Port Waratah funding? Yes ☐

No ☐How will Port Waratah’s support be acknowledged?Click here to enter text.Is there an opportunity for Port Waratah employee involvement in the Yes ☐

project? No ☐If yes, please provide details

Click here to enter text.

Project – Milestone/s

Milestone Timing/Date1 Click here to enter text. Click here to enter text.2 Click here to enter text. Click here to enter text.3 Click here to enter text. Click here to enter text.

Project Benefit/s

Demonstrate the direct benefits, outcomes or impact of the project in the Newcastle LGA and, in particular, portside suburbs?

Benefit To whom1 Click here to enter text. Click here to enter text.2 Click here to enter text. Click here to enter text.3 Click here to enter text. Click here to enter text.

Performance Monitoring & Reporting

How will the performance of the project be evaluated?Click here to enter text.

Please note: A written report is required on the outcomes and impacts of the project on completion.

Supporting Documentation

Please feel free to attach any documentation relevant to the project proposal that may assist in its approval (eg. itemised budget).

Attachment # Title

1 Click here to enter text.

2 Click here to enter text.

Referees

Name: Click here to enter text. Position: Click here to enter text.Organisation: Click here to enter text. Contract number: Click here to enter

text.Name: Click here to enter text. Position: Click here to enter text.Organisation: Click here to enter text. Contract number: Click here to enter

text.

Feedback

How did you hear about the Port Waratah Coal Services Sponsorships & Donations Programme?

Port Waratah Employee ☐Word of Mouth ☐Community Partner ☐Advertisement ☐Website ☐Other ☐

If other, please adviseClick here to enter text.

Certification

I acknowledge that the information provided in this application, to the best of my knowledge, is true and correct.

Signature: ……………………………………… Date: Click here to enter a date.

(Port Waratah Use Only)Approved / Not ApprovedAmount Approved: $ Signature:Date: Comments: