Financial Hardship Application Form

Organisation name(Required)

Contact name(Required)

Contact Phone(Required)

Contact Email(Required)

Role in organisation(Required)

BID Number(Required)

How many members does your organisation currently have?(Required)

Have you reviewed your organisation’s current bookings to ensure you have only booked what you actually need and / or use?(Required)

Yes

Please describe the circumstances of your organisation’s financial hardship.(Required)

Please describe actions you have undertaken to date to improve your organisation’s financial position.(Required)

Does your organisation anticipate any significant financial outgoings or a financial plan for its cash reserves within the next five years? This may include the purchase of major equipment, contributions to infrastructure upgrades etc.(Required)

Yes

What is the estimated expenditure?(Required)

What is it for?(Required)

When do you expect it to occur?(Required)

Can your organisation contribute any of its funds to hire fees?(Required)

Yes

If yes, how much do you estimate you can contribute (in dollars) for the booking period?(Required)

Please attach the following documentation:

Profit and loss statement from the previous two years.

Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 10 MB, Max. files: 5.

Strategic plan

Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 10 MB, Max. files: 5.

Membership fee structure

Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 10 MB.

Any additional supporting information (eg. letter from a SSA, insurance claim, tax bill etc). If you are having trouble uploading the documents, please email them to Community.Facilities@joondalup.wa.gov.au

Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 10 MB, Max. files: 5.

DECLARATION

I have read the fact sheet.(Required)

Yes

Click here to read fact sheet

I am authorized by my organisation’s committee to submit this application.(Required)

Yes

The information I have provided is true and correct.(Required)

Yes

I accept that submission of this application does not guarantee my organisation will be granted a waiver of hire fees, and that my organisation will be contacted to discuss this application in further detail if required.(Required)

Yes

Comments

This field is for validation purposes and should be left unchanged.

Financial Hardship Application Form – Venue Hire Fees and Charges Policy

Please attach the following documentation:

DECLARATION

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Financial Hardship Application Form – Venue Hire Fees and Charges Policy