Community sporting and cultural grant

Are you a paid financial member*

To apply for this grant you must be a paid financial member. If not, please head over to our membership page and join. Membership is $10 per year.

Please complete this form and then head over to our membership page and join as a financial meber to have you application considered.

Please complete the form and someone will be in contact with you shortly to advise you of your membership status.

Is the cleft affected person under 18 years of age?*

This grant is open to school aged children aged between 4 years of age and 18 years of age attending school.

Parent/ Guardian Name*

Prefix First Last

Name of the person completing the application on behalf of the minor.

Applicants Name*

First Last

Applicant must be cleft affected (born witha cleft condition)

Applicants Date of birth*

School Attended*

Gade/Year Level*

This grant is only open to school aged cleft affected individuals.

Postal Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone*

Email*

Sport/ Cultural Activity Details

Sport/ Cultural Activity*

What sport or cultural activity would you like to use this grant towards?

Club/ Associaltion/ Group's name

If this activity is assiciated with a club, association or group, please provide the name.

What is the stimated total yearly cost of this activity?*

Do you have a photo participating in this activity?

This isnt requiered however if awarded the grant we would love to have a photo to accompany the announcement. By providing a photo you are giving us consent to use this image on our media outlets including facebook, instagram, newletters and webapage. If you change your mind simply send us an email at support@cleftpalsqld.org and withdraw your consent for media images. PLEASE NOTE: For privacy reasons, photos must not contain other peoples faces or be of large groups.

Accepted file types: jpg, jpeg, png, gif.

Consent*

Cleftpals QLD Inc will award one person per school term.
Terms run January to March, April to June, July to September and October to December.
Applicants can only win once per calender year. Applicants may only submit one application per term.
Cleftpals QLD Inc. will only make contact with successful applications.

Cleftpals QLD Inc has the right to close the grant without notice.
Cleftpals QLD Inc has the right to reject an application and are not obliged to provide reasons why.

I understand that Cleftpals QLD Inc will not share any information with outside parties.

If your child is successful, any photo you have submitted may be used in a congratuations post. This post will not contain your childs surname, school, age or club details. If your childs photo contains club details on uniforms etc and you do not wish for this to be published, please reconsider the photo selected or edit the photo to remove visible markings.
I may request at any time, my application be withdrawn or my media consent be removed. To do this, I understand that I must send an email to: support@cleftpalsqld.org.au withdrawing said consent.

I agree to the privacy policy.

Phone

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

Community sporting and cultural grant

Cleftpals QLD Inc. Sporting & Cultural Grant Application

Please complete this form and then head over to our membership page and join as a financial meber to have you application considered.

Please complete the form and someone will be in contact with you shortly to advise you of your membership status.

Sport/ Cultural Activity Details

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