JLTAV Regional Support Scheme Application
This request for funding should be submitted to JLTAV at least 6 weeks prior to the event taking place in order to ensure sufficient time to advertise and organise the event. On approval of funding, invoices to be forwarded to JLTAV (jltav@jltav.org.au) for payment prior to the event taking place. Receipts to be reimbursed may be forwarded either before or after the event, accompanied by a reimbursement request form.

Please have the Regional Contact Person fill in this form.

Email address *
Confirm Regional Contact Person's email address *
Must match the email address above - i.e. the first address must be the Regional Contact Person's email address. The organiser's email address is entered further down the form.
Your answer
Region *
Regional Contact Person's Name *
Your answer
Event Organiser's Name *
Your answer
Event Organiser's Email Address *
Your answer
Event Organiser's Phone Number *
Your answer
Event Details
Name of Event *
E.g. North-West Region ICT Workshop; Wodonga Primary PD
Your answer
Date of Event *
If date has not yet been finalised, please list date options.
Your answer
Location *
E.g. School name, venue name
Your answer
Purpose - Teachers
Purpose - Students
Expected Number of Participants *
Your answer
Anticipated Costs
Participants should not be charged for any costs that are covered by this funding.
Should more information be necessary please add this after the dollar figure or estimate.
Venue
Your answer
Catering
Your answer
Stationery/Printing etc
Your answer
Presenter Fee
Your answer
Presenter Transport
Your answer
Presenter Accommodation
Your answer
Other Costs
Your answer
TOTAL COSTS *
Your answer
Divide total cost by number of (anticipated) participants
Your answer
Amount of Financial Support Requested *
Your answer
Method of reimbursement
Invoice
Receipt
Both
Not Applicable
Venue
Catering
Stationery/Printing etc
Presenter Fee
Presenter Transport
Presenter Accommodation
Other
Other Comments
Your answer
Please Note:
Invoices must have the name and date of the event on them.
No reimbursement without original receipts, accompanied by a Regional Support Scheme Reimbursement Request Form (on the JLTAV website) to be sent to the JLTAV office. Please collate all receipts to one Reimbursement Request Form.
A copy of your responses will be emailed to the address you provided.
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