NEW ZEALAND POLICE COUNCIL OF SPORT DISTRICT FUNDING APPLICATION FOR FUNDS

1. Name of organisation/individual

2. Address for correspondence

3.(1) Individuals Yes/No Are you a member of the Police Council of Sport?

3.(2) Group applicants How many of your members belong to the Police Council of Sport?

4. Correct name of payee account to appear on grant cheque and bank account details. 5. Specific description of what the grant is to be used for. Eg: equipment, travel, entry fees, and accommodation. 6.(1) Have you applied to any other organisation for funding for this purpose/event?

(2) If yes (a) who have you a.) applied to for funding? (b) How much funding have b.) you received?

7.Amount requested from the Council $ http://www.policesport.org.nz Page 1 of 2

8. Are you receiving funding Yes/No from NZPCoS Nationally?

9. List names of members benefiting from this grant.

______

I hereby declare that the above information is correct.______Signed

Name & Date ______

Please forward applications to your local DSO.

http://www.policesport.org.nz Page 2 of 2