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1. MAZDA FOUNDATION LIMITED
(ABN 12 465 501 576)
PROJECT NOTIFICATION
PRIORITY AREA OF FOCUS COMMUNITY BASED PROGRAMS FOCUSSED ON YOUTH
HEALTH, WELFARE AND EDUCATION
Please note that during the period 1 October 2008 to 31 March 2010, the Mazda Foundation is
only accepting project notifications in relation to the priority area notified on the Mazda Foundation
website and summarized above.
ORGANISATION NAME:
ORGANISATION ADDRESS & PCODE: STATE: Select
ABN REGISTRATION NUMBER:
CONTACT PERSON & POSITION:
CONTACT DETAILS: TEL NO: FAX NO:
EMAIL:
IS CONFIRMATION OF TAX IS APPLICANT
PLEASE SELECT PLEASE SELECT
ELIGIBILITY AVAILABLE: REGISTERED FOR GST
ENDORSEMENT AS A DEDUCTIBLE
DATE OF ISSUE OF: GIFT RECIPIENT (Insert Date):
(This area must be completed) ENDORSEMENT AS AN INCOME TAX
EXEMPT CHARITY(Insert Date):
OUTLINE OF GRANT REQUEST, INDICATING HOW THE REQUEST RELATES TO THE PRIORITY AREA:
GST EXCL AMOUNT GST AMOUNT GST INCL AMOUNT
AMOUNT OF FUNDING REQUIRED:
DATE PROJECT FUNDS ARE
REQUIRED BY:
Notes: 1. Mazda Foundation will acknowledge receipt of your notification but this should not be seen as in any way indicating
the notification will progress for further detailed consideration.
2. The Foundation does not fund overseas projects/trips in accordance with Australian Taxation Office requirements
applying to the Mazda Foundation.
3. No attachments should be forwarded with this Project Notification.
On completion of the Project Notification follow the instructions as below:
Select FILE; SEND TO; MAIL RECIPIENT (As attachment); TO: info@mazdafoundation.org.au; SUBJECT: Project Notification; SEND
If you have any difficulties returning this form via email please fax to (03) 8540 1920