State Representatives Program

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Financial assistance may be provided to individuals under the age of 25 selected to represent Tasmania or Australia in national or international events, conferences, seminars and sporting championships.

See Terms and Conditions below for more details.

Either apply online, or download and submit the application form in person, or by email:
State Representatives application form(PDF, 380KB)

Apply Online

 
1.pngEnsure you have written advice from the appropriate state or national body confirming this selection (photocopy, download, save as pdf, scan, or take a photo),
2.pngHave your bank account details ready,
3.pngComplete the details below

Applicant Details
testing date of birth options:
Note: only those under 25 years are eligible for funding. (On calendar popup - click on the year to update)

Selection Details

Written advice from a State/National body confirming Applicant’s selection. (photocopy, download, save as pdf, scan, or take a photo)

Electronic Funds Transfer

Bank Account * (required)
Financial Assistance payment must be paid into applicant’s bank. If applicant does not have a bank account, please ensure you complete the parental authorisation section below.

Authorisation

(by Parent/Guardian if applicant is under 18 years)
Tick to confirm declaration * (required)

Terms and Conditions

To be eligible for this financial assistance individuals must:

  1. Be a resident of Burnie or members of a club located in Burnie of which they are representing Tasmania or Australia in sporting events. 

  2. Be a resident of Burnie chosen to represent Tasmania at national conferences, seminars etc who are able to establish a need for financial assistance.

  3. Provide written advice from the appropriate state or national body confirming this selection.

  4. Provide bank account details.

  5. Provide date of birth.

Eligible individuals can apply for financial assistance grants at any time, however, this assistance is limited to $150 per person and will be paid to each eligible individual only once per financial year.

1. Council is committed to upholding your right to privacy. 
2. Personal information collected by Burnie City Council is used in the provision of services. 
3. Information collected will be retained confidentially and disposed of in accordance with requirements of the Personal Information Protection Act 2004. 
4. You have the right to access your own personal information on request.

Please contact the Burnie City Council if:

  • you want to change your contact details
  • you want to place a written information access request
  • you want to discuss a privacy concern

Contact us

Community Development

Email: burnie@burnie.net

Phone: 03 6430 5700

Visit:
80 Wilson St, Burnie
8:30am - 5:00pm
Monday to Friday
closed public holidays
View Map

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