Crime Prevention Unit

Application for Funding 2007 - 2010

Activity

6 month targets

6 months actual

Target met Y/N

Activity

Effort

Effect

Effort

Effect

Target met Y/N

(PDF Adobe Acrobat v5 42KB) | (MS Word 274KB)

Crime Prevention Unit
Schedule A
Application For Project Funding
2007 - 2010

SCHEDULE A

Project Application Template

1. Project Information

Name of Territorial Authority
Name of project
Name of project provider
Project Provider	Name of contact person: Position: Phone: Email: Fax: Address:
Legal status of provider eg, Charitable Trust, Incorporated Society
Relevant professional accreditation of the service provider
Territorial Authority quality assurance practices e.g. What quality assurance standards does your authority require when contracting services?
Description of the project Provide a short synopsis of what you plan to do and what you hope to achieve as an outcome
Duration of project	Start date	Finish date

2. Budget and Ministry of Justice and other agency / service provider contributions

Proposed budget

Please provide a full breakdown of the estimated annual cost of the project. If you are only applying for one year's funding just complete the first column (NB. All figures must be GST exclusive)

Key use of funding	Total Costs of Project	MOJ Funding Year 1	MOJ Funding Year 2	MOJ Funding Year 3
Salaries
Office Accommodation (include Rent and Rates)
Travel (include Fuel, meals, accommodation, vehicle hire)
Telephone (include Internet, mobile) and Power
Personnel Development (include training, professional registration)
Stationery (include printing, office supplies, postage)
Office Equipment (i.e. repairs)
Insurance
Other expenses (i.e. speakers, resource kits)
Funding Sought

Contributions to the project All figures must be GST exclusive

Partner agencies	Contributions (funding, goods and services)
	$ (actual or estimate) per annum	Please state (shaded areas below only) if this contribution is currently been sought or has already been approved
Ministry of Justice	$
Territorial Authority	$
Other government Agencies	$
Other (Specify)	$
Total	$

If other funding is not approved can this project still succeed with Ministry of Justice funding only? Yes/No

If yes please explain

3. Crime problems being addressed

Crime Reduction Strategy (CRS) goal area/s to be addressed Insert or delete rows as necessary	1
	2
	3
	4

Offences /crime risk being targeted

List offence types being targeted with relevant statistics.

Offence Type

Crime statistics for the period (state period).

NB. This could be for the previous 12 months or if there has been an upward trend, data for the last 3 years would be more appropriate.

Target location/s (where appropriate), eg town centre, car parks, public buildings et. If clearly defined area include map.

How the target location/s were identified. e.g. Police data, community safety audits etc.

Target Group/s If the project is aimed at a particular target group describe the group, eg young unlicensed drivers , people under the influence of alcohol etc.

4. Project Deliverables, Targets and Reporting

What type of intervention is this project? e.g. Social Crime Prevention, Situational Crime Prevention, Tertiary Crime Prevention

Does any other agency require outcomes from this project? e.g. MOE a reduction in truancy

Describe the activities you will include in your project

What crime reduction outcome/s do you plan to achieve by undertaking these activities

Annual Targets

Activity Include brief description of key project activities identified on Page 5	Annual Targets
	Effort i.e . what exactly will you do to meet this objective?	Effect i.e. what outcome will you be able to measure from this specific activity?
1
2
3
4
5
6

Crime Prevention Unit
Schedule B
Project Deliverables, Targets and Reporting

Schedule B Project Deliverables, Targets and Reporting

First Six Months (-- to---)

Success factors to date

This may include other outcomes not measured above i.e. soft indicators that may also indicate how project outcomes are progressing

Challenges faced/limiting factors

First Six Monthly Report

Signature

Date Completed:

Second Six Months (-to-)

Success factors to date

Challenges faced/limiting factors

Second Six Monthly Report

Signature

Date Completed:

Complete this page each six months

Explanation of differences between targets and actual delivery or outcomes (if applicable)

Actual contribution of partner agencies over the six month report period

Agency	Financial contribution	Goods and services

If you have further comments, please include them here

5. Expenditure and Confirmation

Actual expenditure

All figures must be GST inclusive

Key use of funding (from page two) e.g. salary, administration etc	FUNDING SPENT
Salaries	$
Office Accommodation (include Rent and Rates)	$
Travel (include Fuel, meals, accommodation, vehicle hire)	$
Telephone (include Internet, mobile) and Power	$
Personnel Development (training, professional registration)	$
Stationery (include printing, office supplies, postage)	$
Office Equipment (i.e. repairs)	$
Insurance	$
Other expenses (i.e. speakers, resource kits)	$
Total MoJ Funds Used	$
FUNDING BALANCE	AMOUNT
MOJ funds bought forward from previous reporting period	$
MOJ funds received in this six month period	$
MOJ funds used (from table above)	$
Balance held at end of this reporting period	$

Statement that funding was used for purpose intended, and request for continued funding

MoJ funding has been fully spent for the purposes intended for period / /

to / /

Yes

If no, please explain how balance remaining will be spent

If you have over expended please explain including how the shortfall will be addressed

Confirmation of information in this report
Signed by ____________________________ being a person with authority to sign On behalf of the _______________________ ____________________________________		Print name: _______________________________ date ______________________________ / / Signature
Phone
Fax
E-mail