Online Form - Community Grant Financial Acquittal and Evaluation Form

1. Grant Details

2. Project Summary

3. Project Evaluation

How many people were involved in the project?

Maximum size of ALL attachments is 976.56 MB

4. Financials

Income (Amount $)

Expenditure (Amount $)

Maximum size of ALL attachments is 976.56 MB

Any unspent grant funds must be returned to the Shire of Northam.

5. Declaration

I declare that the Shire of Northam Community Grant as specified above has been spent in accordance with the purpose and conditions for which it was granted. The attached financial acquittal and project evaluation are a true and correct record of the transactions and outcomes of the project.

Please attach:

  • Photos, feedback, statistics from your project if possible
  • Invoice for withheld funds (if applicable)
Maximum size of ALL attachments is 976.56 MB