Sport NZ Rural Travel Fund Grant Accountability Form

Please fill out this accountability form within one year of receiving a rural travel fund grant.

The form is to be completed and returned before applying for any further grants.

Name of organisation (Required)
Contact person (Required)
Postal address (Required)
PO Box address
Phone (Required)
Email (Required)

Amount received from Grant Fund (Required)
Estimated cost of travel per year for Club/Organisation (Required)
Please give details of how money was spent by providing a detailed breakdown of what the money was spent on (i.e., cost of petrol, cars and/or bus hire) (Required) Alternatively you can attach this information in the 'Supporting' Details section.
Distance travelled to local sport competition (Required)
A brief description of the benefits that have been achieved with these funds? (Required)
In your opinion did the Rural Travel Fund assist your Team/Organisation to increase participation in your local sport competition in rural areas? (Required)

1. Name Signing authority (Required)
1. Position in organisation / title Signing authority (Required)
1. Date Signing authority (Required)
2. Name Signing authority (Required)
2. Position in organisation / title Signing authority (Required)
2. Date Signing authority (Required)

Supporting documents

Please provide copies of the following documents:

Receipts of purchases made using Rural Travel Fund money (fuel vouchers, fuel etc), and/or
Bank account statements showing where the money was spent,
Any other supporting documentation

Please upload in either PDF, PNG or JPG formats.


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