Young Carers Grant Application Form

Closing Date: 5pm, 25 February 2020

You can also download a copy of the application form here.

Certification and Parental or Guardian Permission

By submitting this application I acknowledge that I have read and understood the information made available by Wollondilly Shire Council on the Young Carers Grants Program, including the eligibility criteria and to the best of my knowledge the information provided in this application is true and correct.

Parent/ Guardian Signature

(Only required if applicant is under the age of 18)

Applicant Signature

Personal Details

Need help?

Contact Council’s Community Projects Officer for any assistance in completing your application on 4677 9613 or youth@wollondilly.nsw.gov.au   

Income

Are you receiving any of the following?

Caring Responsibilities

Need help?

Contact Council’s Community Projects Officer for any assistance in completing your application on 4677 9613 or youth@wollondilly.nsw.gov.au   

Expenditure

Needs

Please Note:

  • Council will not provide ongoing maintenance or updates to equipment / technology 
  • Assistance is one-off and not recurrent, applications may be submitted annually (dependent on available funding)

Need help?

Contact Council’s Community Projects Officer for any assistance in completing your application on 4677 9613 or youth@wollondilly.nsw.gov.au   

Application Checklist

Have you:

Privacy Statement

Wollondilly Shire Council is collecting personal information from you on this form for the purpose of assisting the determination process of your application. This information is required for assessment and failure to provide the information may lead to rejection or delays of your application.

 

At any time you have the right to access, view or correct the personal information that you have provided. Please also note that information supplied on this document may be the subject of a request to access information under the Government Information (Public Access) Act 2009.

Need help?

Contact Council’s Community Projects Officer for any assistance in completing your application on 4677 9613 or youth@wollondilly.nsw.gov.au