CHT Aged Care Fund Grant – Stage 2

CHT Aged Care Fund Grant

Thank you for your interest in the CHT Aged Care Fund.

Please complete this Expression of Interest (EOI) form and then press submit.

Any instructions in italics on this EOI may be removed.

Email any supporting documentation to agedcarefund@cht.co.nz

Note EOI applications will be accepted from Monday 14 September 2020 to Monday 16 November 2020.

APPLICATION FORM

    Contact Details
    For Organisation / Institution / Individual
    Postal Address
    Name of the Main Contact
    Names of Key People in your Organisation / Institution
    Tell Us About The Project
    Projects must be for the advancement of promotion of work among older people with a specific focus on:

    1​ - Access to Care
    2​ - Research
    3 - Workforce Development

    What will the benefit of the project be?
    Timetable for the Project
    Key Activities/Milestones
    Project Team Names & Roles
    If Your Project is a Research Project, Please Outline:
    If you are successful in receiving a grant from the CHT Aged Care Fund for your project, do you agree to relevant details of the project and outcome being published?

    YESNO

    Financial Details of the Project
    Are you GST registered?

    YESNO

    If you are NOT registered for GST, the GST component of your project costs will be funded.
    If you are registered for GST do not include GST in your project costs, as the Fund will not fund the GST component. Round figures to the nearest dollar.
    Please indicate with an asterisk if any income sources have not been confirmed.

    Attach budget documents here:
    Additional Information

    The following information is required from ALL Organisation and Institution applicants:

    Annual Accounts for the last financial year (preferably audited)
    A copy of the budget and quotations to support your funding request
    Please Download and Sign
    This Declaration Form FILE(.PDF), then attach here: