Let's Light Up Football Application Form

Submitting the Application

Information must be entered into all mandatory fields indicated with an asterisk
Click the 'Submit' button at the end of form to submit the application
Once an application has been submitted, it cannot be changed
The system will not allow applications to be submitted after the closing date and time
Application must be completed in one sitting. Applications cannot be saved and then returned to at a late date.
Suggestion, complete the application form offline, e.g. in Microsoft Word prior to beginning the online application. A preview of the application is available on the facilities website
To move to the next page, click 'Next'
Applications Open Tuesday 30th of April 2019
Applications close Monday 15th of July 2019, 4pm

Application Details
*Field is compulsory to complete
Please specify whether you are a club, association, local council or school?*
Name of club, association, local council or school*
Applicant Name*
First Last
Applicant Contact Email*

Contact Phone Number*
Position Held*
President, Secretary, etc.

Project Information
Facility Name*
E.g. Valentine Sports Park
Field Name*
E.g Field 2
Field Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Association*
What local council is the facility located in?*
What State Electorate is the facility located in?*
Is this facility the clubs/associations home ground or an alternate venue that the club uses*
Clubs Home Ground
Associations Home Ground
Alternative Venue
Current lighting status at the facility*
No floodlighting currently exists
Less than 50 lux
Between 50 and 100 lux
Between 100 and 200 lux
Unsure
Project Details
Project Name*
Is development consent required for the lighting project*
Yes
No
Other
If yes, evidence must be provided. See ATTACHMENTS page 4
If other, please provide further detail*
Type of Lighting Project*
New Floodlighting (new site)
Upgrading poles and lamps
Upgrading lamps only
Adding additional poles
Describe the current lighting situation and what this project will involve?*
Explain what the project will involve, i.e. number of new poles, number of new lamps, etc.
Why is the project needed?*
How will this lighting project benefit your club?*
Anticipated project start date*
Date Format: DD slash MM slash YYYY

Anticipated project end date*
Date Format: DD slash MM slash YYYY

Financial Details
TOTAL PROJECT COST*
Total Project Cost MUST Equal Income Total
Funding
1. Funding requested from Let's Light Up Football*
2. Confirmed funding from Local Council*
3. Confirmed funding club and/or association*
If no club/association funding please enter $0 in the provided text box
INCOME TOTAL*
(ADD) 1 + 2 + 3 = INCOME TOTAL

Attachments
Letter of support from local football association*
Letter of support from local council*
Evidence of club's contribution*
E.g Bank Statement
Project Quotation OR Invoice of Similar Type Project*
Development consent from council or letter confirming development consent is not required*
NOTE: Council letter of support can include development consent confirmation
Club and/or Association Facility Plan
Council Open Space Strategy or Similar Document

Declaration By Applicant
In submitting this application, I acknowledge that if successful, details about the project such as the applicant organisations name, project name and description, local council and amount of grant may be used by Football NSW for promotional purposes
Declaration acknowledged*
Yes, I acknowledge and accept
The declaration below must be agreed to by a person who has delegated authority to sign on behalf of the organisation. e,g. President, Board Member or authorised staff member
Name*
First Last
Signiture is approval on behalf of the organisation to submit the application*
Yes

Let’s Light Up Football Application Form

Let's Light Up Football Application Form

Step 1 of 6

Application Details

Project Information

Project Details

Financial Details

Funding

Attachments

Declaration By Applicant

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