Health Football and Community Facilities Funding

Club Name*
Venue Location*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
City Council Name*
Description of Upgrade*
Please provide an in-depth description on the proposed upgrades.
Total Value of Upgrade*
Total Value of Third Party Contribution*

Please state the name and value of the third party contribution i.e (LGA, State Government etc).
Proposed Outcomes of Upgrade*
Please outline the proposed outcomes from the upgrade i.e meeting excess capacity, increasing female participation, engaging culturally diverse communities etc.
Club Contact*
First Last
Contact Email*
Club Role*
Additional Documents
Drop files here or

Max. file size: 128 MB.
Please upload any additional documents for your facility funding proposal.