Fl Victoria Country Subway Junior Carnival Funding Page 3
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3AFL Victoria Country Subway Junior Carnival Funding
Declaration
I state that the information in this application and attachments is to the best of my knowledge true and correct. I agree that the information provided in this application
will be used by AFL Victoria Country for assessment and reporting. I understand that this is an application only and may not necessarily result in funding approval. I
understand that AFL Victoria Country may require further information to assist in the assessment of this application and I will forward on any requested information.
Signature*
Date
Printed name
AFLVC Area
AFL Victoria Country Endorsement
WorkSafe AFL Victoria Country Football Operations Manager- Country Signature
Date
Approval
(AFL Victoria Country Head Office Use Only)
Date Application Received
Date Application Processed
AFLVC Approval/Rejected (Signature)
Date
Printed name
Applicant Notified (Name/Date)
FUNDING DISTRIBUTION DETAILS
Amount Approved $
Distribution method
Review Notes:
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