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YELLOW FISH ROAD APPLICATION FORM

NAME OF ORGANISATION:
ADDRESS:
POSTCODE:
NAME OF PERSON APPLYING ON BEHALF OF THE ORGANISATION:
PHONE:
FAX:
Email:
IS THE APPLICANT (please select)
IS THE APPLICANT A MEMBER OF THE SIA?

IF NO, WOULD THE APPLICANT CONSIDER
BECOMING A MEMBER IF ADMITTED TO
THE YELLOW FISH ROAD PROGRAM?

DOES THE APPLICANT HAVE FUNDING TO SUPPORT THE ORGANISATION AND MANAGEMENT OF THE PROGRAM (give details)

VALUE OF FUNDS WHICH ARE OR WILL BE MADE AVAILABLE:

IS THERE ANY ADDITIONAL SUPPORT IN KIND COMPRISING GOODS & SERVICES WHICH WILL BE MADE AVAILABLE (give details)

HAS THE APPLICANT HAD EXPERIENCE IN ORGANISING & MANAGING COMMUNITY BASED EDUCATION & AWARENESS PROGRAMS (give details)

WHO ARE THE PERSONS, THEIR POSITION AND EXPERIENCE, WHO WILL MANAGE THE PROGRAM (give details)

LIST THE SCHOOLS AND COMMUNITY GROUPS WHICH YOU PROPOSE WILL ASSIST WITH THE PROGRAM

HAVE SOME OR ALL OF THESE GROUPS BEEN APPROACHED WITH REGARD TO THE YELLOW FISH ROAD PROGRAM (list those who have been approached & have agreed to assist)

WHAT IS YOUR ORGANISATION'S PREFERRED TIME FRAME TO:
COMMENCE THE PROGRAM
PROGRESSIVELY WORK THROUGH YOUR CATCHMENT/DISTRICT
COMPLETE THE DRAIN MARKING PROGRAM

PLEASE OUTLINE A BRIEF STRATEGY (IN DOT POINT FORM ONLY) OF HOW YOU PROPOSE TO GO ABOUT THE YELLOW FISH ROAD PROGRAM

(Applicants may send any additional supporting information which they may like considered by the Assessment Panel to the SIA)

FOLLOW UP SURVEY AND ASSESSMENT.

Applicants must carry out an assessment of their program between 6 and 12 months after implementation in their catchment or district. This survey may take many forms, and the more feedback available the better managed future programs can become. If a catchment has litter traps fitted, a volume or weight comparison prior to and after the Program would measure community behavior change. As a minimum, the SIA recommends a "fish" recognition questionnaire randomly conducted in local shopping centres. A copy of all survey results should be forwarded to the SIA as soon as possible, after compilation, to assist the national Program.

SIA National GPO Box 1261 Canberra ACT 2601
Phone: 1800 761 777 Fax: 1800 659 382 Email: NationalAdmin@stormwater.asn.au