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Vitality Grant Proposal

  1. Vitality Grant Proposal
    This proposal form will take an average of 1 hour to complete. Please read through all of the question/submission fields before you begin to ensure that you have all materials at the ready. Do not close this web browser if you need to pause your application and return to it later.
  2. PROPOSAL - SCHEDULE A
  3. First Name Last Name, separate each applicant name with a comma
  4. First Name Last Name
  5. Primary contact number
  6. Applicant Type (please check one):
  7. From: DD/MM/YYYY To: DD/MM/YYYY
  8. SECTION 2. PROJECT DESCRIPTION
  9. SECTION 3. EXPECTED RESULTS/OUTCOMES
  10. SECTION 4. PARTNERSHIPS AND SUPPORTS
  11. Click the 'Browse' button and select the relevant files for upload from your device. We accept .PDF .JPG and .PNG
  12. Optional
  13. Optional
  14. By submitting this proposal, I/We agree to comply with the requirements stated in this proposal.
    DECLARATION The project lead declares that it has complied in every respect with all the instructions, and that it has satisfied itself fully relative to all matters and conditions with respect to the general conditions of the agreement and all relevant information to which this application pertains.
  15. This field will serve as your final digital signature, indicating that all of the above fields and submitted items have been completed accurately to the best of your knowledge.
  16. The personal information on this form is collected under the authority of Section 33(c) the Freedom of Information and Protection of Privacy Act, for the purpose of ensuring that an individual is eligible for the Vitality Grant program and will be protected under the provisions of the Act. Personal information, will not be published unless expressed consent is provided. Email addresses will be utilized to facilitate contact if no other means are available.
  17. Leave This Blank:

  18. This field is not part of the form submission.