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The Stephenson Fund - Application Introduction
  • You are able to upload supporting documents if you choose at the relevant sections, and also at the end of the form.

  • You are able to make the text response boxes bigger by dragging the right lower corner into a larger rectangle. 

  • * Indicates a required field

  • We suggest you read through the application form and prepare your answers before beginning so you'll have all the necessary information ready to assist in completing your form.  

  • Please note: you will not be able to save information in your form part way through then return to it - this application form must be completed in one session or information will be lost.

Please indicate you have read the accompanying FULL APPLICATION GUILDELINES before completing this form. You will find these as a link on the QEII Stephenson Fund website page.

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Section 1 - Applicant Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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If registered, please include your GST number here
Section 2 - Covenant Information
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e.g. 5-12-123
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Section 3 - Project Information
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Please provide a brief outline of the proposed project, including:

  • project area (ha)
  • what you plan to do
  • when project works will take place
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Section 4 - Project Costs

We require an outline of the estimated costs and work involved in your project.

Please read the following information before completing the budget outline in the following section, and speak with your Regional Representative if you have any questions.

  1. Applications must include a 50% financial or in-kind contribution toward total project costs by the applicant. (Note: unless you are applying due to hardship. Please ensure you have provided sufficient information in Section 3).

 

  1. Please outline in the budget fields below if your 50% contribution is financial or in-kind. In-kind contributions can include planning time, labour, transport costs, and machinery costs. If you are including in-kind contributions, please state the anticipated number of work hours.

In-kind labour

 $25/hour

Mileage

 0.79c/km

Use of personal  vehicles/machinery
e.g.  tractor, quad bike, ute

 Up to $40/day

 

 

  1. Please outline in the budget fields below if you intend to engage a contractor during your project and include a quote for those works with your application.

  2. For materials/equipment, we require a quote or an example of the order included with your application.

  3. If you plan to include funding from another source in addition to your 50% contribution, please include that figure in your budget outline below.

Budget Outline

Please outline below how you propose to split the cost of materials/equipment that would be purchased and the work required to achieve your project goals (remember your contribution and QEII's needs to be 50/50, unless you are applying due to hardship).

Please provide GST inclusive figures only.

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You can also upload your own budget outline document - here is an example of how we would like a budget document submitted (please provide GST inclusive figures only)

Description of
- materials
- labour/work

 

QEII funding request 

 

Your 
contribution

 

Additional funds from a 
separate grant if applicable 

 

Total 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTALS (incl GST) 

$ 

$ 

$ 

$ 


Section 5 - If Your Application is Successful

If you are successful in receiving a grant via the Stephenson Fund, we would like to ensure the invoicing and reimbursement process works well for both parties. We will provide an invoice template you may choose to use when seeking reimbursement, and the table below outlines the options that will be available to you.

Projects approved up to $5,000 grant contribution

 

Projects approved greater than $5,000 grant contribution

 

Option 1

All projects are able to submit one total/final invoice covering the entirety of their grant for reimbursement when the project is complete.  At this point, you will be required to submit evidence of your total financial or in-kind contribution.

 

Option 1

All projects are able to submit one total/final invoice covering the entirety of their grant for reimbursement when the project is complete. At this point, you will be required to submit evidence of your total financial or in-kind contribution.

 

Option 2

You will be able to request up to 50% funding up-front/before project works begin.

 

 

Option 2

You will be able to request a maximum $2,500 funding up-front/before project works begin.

 

 

 

Option 3

Invoices may be submitted/progress payments made as expenses are incurred, however the minimum amount you are able to invoice for at any one time is $2,000 (note: you may submit more than once invoice at a time, as long as they total minimum $2,000). In this option, you will also be required to provide evidence of your financial or in-kind contributions to this point. 

 

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Section 6 - Term & Conditions

Please read this section before submitting your application

  1. Grant projects must be within registered QEII covenants and must be consistent with the objectives, restrictions, and obligations of those covenants.

  2. Any planting work carried out as part of grant projects must use eco-sourced site-appropriate indigenous species from the same ecological district as the covenant in which they are being planted (see QEII’s guidelines on eco-sourcing).

  3. QEII is not responsible for any project costs not included in this application.

  4. Unless the parties agree otherwise in writing, QEII may withhold or withdraw funding, and may seek reimbursement of funds, if:

    a) Grant funds are spent other than as set out in this agreement

    b) The recipient fails to make contact regarding the grant for over 12 months

    c) Grant funds are not spent within 12 months (unless an extension request has been approved)

    d) The project is unable to be completed

    e) QEII reasonably considers that the grantee has brought QEII into disrepute

    f) The recipient is insolvent or bankrupt, or is in receivership or liquidation

    g) The recipient breaches any condition of this agreement

  5. If total project costs are less than the total cost outlined in the budget in the funding agreement, actual costs will be shared between QEII and the recipient in the same ratio as outlined in that budget.

  6. If total project costs are less than any QEII grant payments made in advance, the recipient will return unused funds to QEII.

  7. No party is liable for failure to perform obligations under this agreement if such failure is a result of an unforeseeable circumstance preventing fulfilment of the obligations, including events such as fire, flood, earthquake, storm, or other such natural disaster.

  8. Upon project completion, the recipient will provide QEII a final project report on the approved template, and before & after project photos.

  9. QEII may share project information for promotional purposes or for purposes related to this funding agreement. Project information includes covenant biodiversity information, photos, and material submitted with applications and project reports. Information may be shared via QEII’s Open Space magazine, website, or social media channels. QEII will securely store all information provided by the recipient. QEII’s privacy policy can be found on our website.

  10. QEII will deal with any release of information in accordance with the purposes and principles of the Official Information Act 1982 and the Privacy Act 1993.

  11. The recipient will ensure that the project complies with the laws of New Zealand.

  12. No partnership, joint venture, principal/agent, or employer/employee relationship exists between QEII National Trust and the recipient in relation to the grant project.

  13. The recipient shall ensure all resource consents or other consents required from any local authority are obtained prior to the commencement of the project and will comply with such consents.

  14. The recipient will acknowledge QEII National Trust and The Stephenson Fund in any publicity resulting from the project.

  15. In the event of a dispute related to this grant, both the recipient and QEII will act in good faith and attempt to resolve any dispute by meeting within 10 working days of one giving the other written notice of a dispute. If the dispute is not resolved it will be submitted to arbitration in accordance with the Arbitration Act 1996.

  16. QEII is committed to a positive health and safety culture. The wellbeing of persons involved in the grant projects is fundamental to the success of the grant project. 

  17. The recipient must ensure that the project complies with the Health and Safety at Work Act 2015 (HSWA), including applicable regulations, codes of practice and industry best practice and associated HSWA legislation.

  18. Where practicable, the recipient must ensure that a site and project-specific safety plan (identifying all persons, hazards, risks, and control measures etc.) is in place prior to project commencement. QEII may request a copy of this plan at any time. 

  19. The recipient must ensure that all contractors, sub-contractors and/or volunteers involved in the project comply with and cooperate in all health and safety obligations. Where multiple Persons Conducting a Business or Undertaking (PCBU) are engaged, all PCBUs must consult, cooperate, and coordinate with each other about health and safety matters prior to, and throughout the project.

  20. If, at any stage during the project, QEII observes activities or procedures that do not comply with the safety plan or that expose any person to undue risk, QEII may issue a ‘Stop Work’ notice to the recipient, which the recipient must comply with. 

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Section 7 - Submit Application

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