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 Please upload any additional documents for your facility funding proposal.