Producer Innovation Fast-Track
Application Form

Please complete all fields and submit your application to fasttrack@mla.com.au

For more information, contact:

Renelle Jeffrey

Manager - Producer Innovation Partnerships

MLA Donor Company (MDC)

M: +61 414 255 058

E: fasttrack@mla.com.au

Project title:

Project stream (select the relevant stream for your project)

☐ Producer-led accelerated adoption of innovations to improve on-farm performance

☐ Producer-led innovations resulting in new products, brands and value chains

☐ Producer-led new ventures and start-ups

PRIMARY contact details

First name	Surname
Mailing address
Phone	Mobile
Email

Contracting organisation details

Name
Registered Business Name
ABN
Street Address
Postal Address
Phone	Mobile
Email (if different from above)

PARTICIPATING MEMBERS of GROUPS (add rows as required). Only to be completed when more than one business is contributing to the project cash contribution

Name	Address	Contact number	Email
Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.

Timeframe

PROJECT START DATE: Click or tap here to enter text.	PROJECT COMPLETION DATE: Click or tap here to enter text.

PROJECT DETAILS

What is the problem, challenge or opportunity faced by producers or customers the project will address? Why is it a problem or opportunity? Click or tap here to enter text.

What is the proposed solution? How will the solution accelerate productivity, profitability or industry competitiveness? Click or tap here to enter text.

What benefits will the project deliver to producers, their business and the industry in the longer term? Click or tap here to enter text.

PROJECT OBJECTIVES (Insert up to three objectives your project will deliver on)

Click or tap here to enter text.

METHOD (Briefly describe the proposed method or sequence of events to deliver the project)

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Budget

BUDGET ITEM*	TOTAL ($)
Fees
Insert who fees are paid to (ex GST) and for what services they are providing. Add rows as needed Click or tap here to enter text.	Click or tap here to enter text.
Operating Items
List operating items (ex GST). Add rows as needed Click or tap here to enter text.	Click or tap here to enter text.
SUB TOTAL PROJECT COST	A	Click or tap here to enter text.
Plus 8% of SUB TOTAL (MDC Access fee)	B	Click or tap here to enter text.
TOTAL CONTRACT VALUE	A+B	Click or tap here to enter text.

Funding contributions

Funding percentage	Cash Contribution to the project (ex GST)	Access Fee	TOTAL (ex GST)
Producer	25% of A above	Click or tap here to enter text.	25% of B above	Click or tap here to enter text.
MLA / MDC	75% of A above	Click or tap here to enter text.	75% of B above	Click or tap here to enter text.
TOTAL	Click or tap here to enter text.	Click or tap here to enter text.

Milestones (GST exclusive)

Milestone start date	Milestones	Service Provider	Fees (ex GST)	Expenses (operating) Ex GST	TOTAL (ex GST)
Click or tap here to enter text.	Milestone 1 – contract executed and one on one consultation completed. Confirmation of stakeholder contact / group you can validate your project assumptions with? Have they been engaged in the project to date	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text.	Go / No go review meeting with MDC	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text.	Milestone 2 – Milestone report	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
Click or tap here to enter text.	Milestone 3 – Final report including lessons learnt discussion with MDC consultants	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.	Click or tap here to enter text.
TOTAL PROJECT COST	$ Click or tap here to enter text.	$ Click or tap here to enter text.	$ Click or tap here to enter text.