A NSW Government website

Application for Authority to Fundraise

Section A - Applicant Contact Details
Section B- Fundraiser Activity/ Event Details
Section C- Insurance and Permits
Do you have Public Liability insurance for this activity/ event? *
Do you have any activity required permits from council/ government bodies for the activity/ event? *
Section D -Fundraising Budget Income (Estimate)
Section E - Fundraising Expenditure (Estimate)
Section F- Other organisation
Is the activity/ event raising money for another organisation *

Fundraiser acknowledgement by submitting the form I/we acknowledge the following:

  • I have read the Hunter New England Local Health District fundraising guidelines and indemnify Hunter New England Local Health District from any claims for injuries or damage arising at or from the event, product or service.
  • I understand that I/we must comply with the Charitable Fundraising Act NSW 1991. I or my organisation will be solely responsible for securing any necessary permits, authorities to fundraise or licenses.
  • I understand that I or my organisation is solely responsible for ensuring the safety of the event.
  • I understand that Hunter New England Local Health District reserves the right to withdraw approval or fundraising at any time, should the organiser/s fail to comply with fundraising guidelines.
  • I understand that Hunter New England Local Health District will not be liable for any expenses associated with the event or fundraiser.
  • I confirm that all information in this document is correct at the time of submission and any alterations to the information after the approval process will be forwarded in writing to Hunter New England Local Health District for further review prior to the event or fundraiser.
  • I understand that all funds raised from the event/fundraiser must be forwarded to Hunter New England Local Health District within thirty (30) days of the end date of the event.
  • I understand that all media or advertising must follow the guidelines in regard to publicity. Any of Hunter New England Local Health District’s logos must be clearly visible and it must be clear that the purpose of the event is to raise funds for the approved service/facility. An approved logo must also be provided to the organiser/s.