Application Form – Hepburn White Ribbon Committee – Sporting Club/Recreation Provider Initiative

Hepburn White Ribbon Committee - Sporting Club and Recreation Provider Initiative - Application Form

Please complete the following application. You are required to provide information in regards to your club or groups desired event, program or initiative, and estimated costs associated.

Step 1 of 3

Name:*
First Last
Email:*
Contact number:*
Club or group name:*

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1. Please describe what your club or group proposes to do in partnership with the Hepburn White Ribbon Committee:*
2. Please provide an estimated breakdown of the costs for the proposed activities outlined in question 2:*
3. My club or group commits to:*
- Conducting a formal acknowledgement to White Ribbon at the event, initiative or program
- Allowing for White Ribbon merchandise to be sold at the event, initiative or program
- Providing a donation to the Hepburn White Ribbon Committee if any revenue is raised during activities
- Providing photos to the Hepburn White Ribbon Committee suitable for future promotional purposes. Please note, these may be shared in future publications and social media posts by Council
- Submitting an acquittal of the outcomes of your groups project, including final break down of costs
4. Please provide any other information that you think might be helpful for the Hepburn White Ribbon Committee to consider when assessing your application:

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I declare that the details provided in this application are correct and I am authorised to sign on behalf of the organisation applying to the Hepburn White Ribbon Committee:*

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