Lorna Stone Development Award


Lorna Stone Development Award Application Form


The Lorna Stone Development Award is provided on an annual basis to a person with a disability up to the value of $5,000.


It aims to encourage education and independence for people with a disability, and seeks to support them through the provision of services or purchase of equipment. Applicants must be aged 0 to 65 years and currently access or attend a Sylvanvale service.


To apply, please complete and submit the online application form provided below. Please include at least one quote that shows the cost of any products or services you are requesting. The closing date for applications is 5pm AEST on Friday 24 September 2021.

Please fill out all fields and do not leave any spaces blank.

Person Making the Application



Applicant Details


Sylvanvale Service(s) the applicant participates in:
Describe the activity or equipment you are applying for and how it will benefit the applicant:

When & how will the Award be expended?


Date Commenced Date Completed Description

What is the budget? (please include any postage/delivery costs)


Description Amount
Have you attached at least one quote that shows the cost of any products or services you are requesting?
How did you hear about the award?

Declaration


I declare that:
1. I have read, understood and agree to abide by the Terms and Conditions of the Application Form.
2. If I win this award, I agree to participate in the award film production on Wednesday 20 October 2021.
3. The information given on this Application Form and accompanying documentation is true and accurate.
4. I have the authority and capacity on my own behalf, and on behalf of the individual in whose name this application is submitted, to make this application.

I confirm that I have read and understand the Terms and Conditions:
Yes


Signed for on behalf of the applicant


Please sign in the space below.


Once you click ‘Submit Form’ please wait for a green confirmation message to appear on this screen.

ACCESSIBILITY OPTIONS
ACCESSIBILITY OPTIONS