Partnership Proposal form

Organisation

Tell us about your organisation

Organisation name

Primary contact name (This should be someone who can answer questions and provide additional information about the proposal if requested)

Email address

Website

Social media handles

Short description of your organisation including its purpose

What type of organisation is it?(Please select one)Community groupNot-for-profitGovernmentCommercialOther

If you selected other above please indicate what kind of organisation you are?

Partnership proposal

Is this proposal(Please select one)A request to renew or extend an existing partnershipA new proposal

Short description of your proposal

Start date and end date (please list)

What are the goals for your proposal?

How will partnering with Libraries ACT support the goal/s?

Short description of your organisation including its purpose

What will you contribute?

What are you asking Libraries ACT to contribute?

Is your proposal related to a grant submission?(Please select one)Yes (if yes please provide details on the field below)No

If yes please provide details including the name of the granting organisation and timeframes involved

Supporting activities

What can your organisation contribute or participate in as a partner with Libraries ACT?

• Active promotion and sharing of Libraries ACT information with your audience and supporters (e.g. library membership, multicultural services, digital resources)
• Active promotion and sharing of Libraries ACT information with your audience and supporters (e.g. library membership, multicultural services, digital resources)
• Supporting Libraries ACT and ACT Government outreach activities by (please describe)
• Other (please list below)

Other (please list)

Your audience

How many people do you expect your proposal will involve/reach?

Who is/are the main audience/s for this proposal? (Choose all that apply)

• Aboriginal and Torres Strait Islander people
• Adult learners
• Carers
• Children under 5 years of age
• Children 5 to 12 years of age
• Culturally and Linguistically Diverse communities
• General public
• Historians
• LGBTIQA+ community
• Parents/grandparents
• People living with a disability
• Researchers
• Seniors
• Vulnerable or socially isolated people
• Young people aged 12-25
• Other (please list below)

Other (please list)

Priorities and focus areas

What are your organisation’s priorities and focus areas? (Choose all that apply)

• Canberra’s history and heritage
• Early literacy and family literacy
• Health and wellbeing
• Identity and belonging
• Inclusion, diversity and reconciliation
• Lifelong learning
• Living in a digital world
• Reading and literacy
• Social connection
• Sustainability
• Other (please list below)

Other (please list)

Room bookings

Does your proposal require use of a library community room?YesNo(Please select one)

Day of the week

Date (for recurring events please list all required dates)

Start time (including set up)

End time (including pack up)

Library location

Expected number of people participating

Conditions of partnership expression of interest

By submitting a partnership proposal you agree to the Libraries ACT Guidelines for Partnerships.(Select yes if you agree to Libraries ACT Guidelines for Partnerships)Yes