Pilbara Lore Practice Form

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Pilbara Lore Practice Form

Program 4: Cultural Support

4.1 Pilbara Lore Practice

This program provides up to $3,000 for each IBN boy going through Lore in the Pilbara, and up to $2,000 for each Pilbara Lore Ground.

Applicant details

Name(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Gender

Male

Female

Name of boy attending Lore Practice (if relevant)(Required)

Language Group(Required)

Yinhawangka

Banyjima

Nyiyaparli

Non-IBN legal carer

Current home address(Required)

Postcode

Phone(Required)

Email address

Have your personal details changed?(Required)

No

Yes (If yes, please complete an ‘Update personal details’ form and attach it to your application.)

Drop files here or

Max. file size: 10 MB.

I am applying:(Required)

For support to attend Lore Practice (IBN boy)

For Pilbara Lore ground support – Fuel only (responsible IBN Elder)

Dates(Required)

Pilbara Lore Ground(Required)

Items for purchase (NO CASH PAYMENTS)

For details on what expenses IBN will cover, please see the IBN 2021-22 Community Programs
Handbook, or the IBN website www.ibngroup.com.au

List(Required)

Description of item (what is the money for?)

Name of supplier (who is being paid?)

Amount

Comments

Food and fuel – please tick your preferred payment method(Required)

Food voucher

Food card

Fuel voucher

Fuel card

Required Documents (please attach)

Required Documents (please attach)(Required)

Supplier quotes or invoices including payment details

IBN ‘Update Personal Details’ form (if required).

Declaration

I declare that the information I have provided in this form is true and correct and the benefits requested are for my own use.
I agree that IBN may share my information with other organisations for application assessment purposes.

Signature

Drop files here or

Max. file size: 10 MB.

All applications must be approved by the IBN Cultural Support Officer.

Signature

Drop files here or

Max. file size: 10 MB.

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CONTACT IBN

FREECALL: 1800 014 401 admin@ibngroup.com.au www.ibngroup.com.au

IBN Group acknowledges the the Yinhawangka, Banyjima and Nyiyaparli people as the traditional people in and around the Hamersley Ranges and custodians of the land.

Aboriginal and Torres Strait Islander peoples should be aware that this website and associated links may contain images, voices or names of people who have passed away.

IBN Group respects the community’s cultural protocols, and we acknowledge that images of IBN members, IBN children and IBN staff are featured throughout the website. If any image featured on our website needs to be removed for cultural purposes, please contact our Communications Officer on 9140 0900 or communications@ibngroup.com.au

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