Squiz Consult

This report back form is for Community Grants, Community Events, Major Community and Premier Events, City Service and City Projects, Community Arts and Heritage Projects Grants, and Dunedin regional events fund grants allocated to organisations by the Dunedin City Council. All grant recipients must complete this form as agreed with the Council.

Please complete all questions in the report.

Additional information such as an evaluation or financial statement, or additional information for Dunedin regional events fund grants can be provided to the DCC with this report by using the Reports, financials and supporting documents section.

When did you receive your grant funding? * (required) (please specify month and year the monies were received)

Organisation name * (required)

Project/event name * (required)

Contact name

Postal address

Suburb

Town/City

Postcode Postcode Finder (new window)

Contact phone number

Email address (please enter a valid email address - name@domain, name.name@domain (eg name@name.co.nz, name.name@name.org etc)

1. Purpose for which you received the grant? (250 words)

Include a copy of the Financial Statements and Report that relate to the year you received and spent this grant (clearly showing the DCC grants funding) please upload your documents at the end of this form.

2. Amount granted by Dunedin City Council? * (required)

3. Total cost of the project * (required)

4. Describe where other funding came from so you could proceed with the project/event/activity. (250 words)

4b. Volunteers labour/in kind supported contributed by other organisations? (250 words)

5. Is your project / event / activity completed? If not, please explain why (250 words)

6. How did the wider organisation benefit from the DCC grant? (250 words)

8. How did the wider community benefit from the DCC grant? (250 words)

9. What DCC strategy themes/outcomes did your organisation meet through this grant? (250 words)

10. How did your organisation acknowledge the support of the Council grant? (250 words)

11. Tell us what went well? And what didn’t go well? (250 words)

12. What do you plan to do next? (250 words)

Reports, financials and supporting documents

Financial Statements and Report (Files may only be of .doc, .docx, .xls, .jpg, .jpeg or .pdf type and no larger than 10MB in file size.)

Supporting information (You may attach a supporting file. Files may only be of .doc, .docx, .jpg, .jpeg or .pdf type and no larger than 10MB in file size.)

You will receive a Thank-you page in this browser window and a confirmation email upon successful submission of this online form.
If the form does not submit successfully, there will be an error message listed at the top of the form