Name of organisation/
group/ individual
applying:
Address:
Postcode:
1. Please give us an overview of who you/your group/organisation/sponsoring organisation are and what types of activities/projects you provide/ deliver? Please give any website details, if applicable.
2. Please give a brief description of what you want to spend the money on, (i.e. what your project is) including an overview of the activities you/ your group/organisation/sponsoring organisation plan to provide. Please also tell us where you plan to run/ deliver your project. Please use additional paper if required.(Max of 300 words)
3. Please tell us which ward priorities your project relates to and show how your project meets them (see Supporting Documents).
4. How many people will your project benefit and which of the following groups do theyfit into?
Number of anticipated beneficiaries:
Under 10 yrs 11-19 yrs 20-29 yrs 30-39 yrs 40-49 yrs 50-59 yrs 60+ yrs
White British Other White Black British Other Black Asian British Other Asian Other
Other (Please state):
Disability (Please state):
5. How will you/your group/organisation ensure your project promotes Social Inclusion (enabling people or communities to fully participate in society)?
6. How will the project address issues of inequality, equal opportunities and community cohesion?
* If you/ your group/organisation have an Equal Opportunities Policy, please ensure you enclose a copy with this application.
7. Why do you feel that this project is important and should be supported by the community?
8. Do you have any evidence of support from the local community i.e. they have approached you/your group/organisation and shown/ expressed a need for this project? How will you ensure the project is designed to meet those needs?
9. How will the target audience benefit and how will this be measured against your anticipated outcomes? What types of record of information will you use i.e. register, evaluation forms etc?
10. Please provide a breakdown of how you plan to spend the amount applied for. Please ensure you check the costing and availability of your chosen venue (if applicable), before submitting your funding application. Remember, the community and funders will be looking for maximum value for money, from a range of projects and the maximum amount you can apply for is £1500.
Material/ Resource / Project Costs£
£
£
£
£
£
£
Total Cost of Project / £
Total amount applied for:
11. How will the project be sustained in the future?
12. Have you/your group/organisation received any funding in the past 24 months e.g. Area Committee/Area Boards, Lottery, Luton Borough Council, previous PB funding etc?
Yes No
If yes, please specify funder and amount, as any funding not declared may result in this application being void.
13. Please include with your application:Yes No
Two letters of community support(where possible)
*Any quotes for equipment/materials etc. (on supplier’s letterhead)
Constitution/set of rules for organisation/sponsoring organisation
(where possible)
Letter from sponsoring organisation (if you are an individual
applying for funding without the back up of a community group)
Evidence that the project falls within the funding area
Additional supporting material
*A set of your group/organisation’s most recent, audited accounts
(If applicable)
A copy of your group/ organisations most recent bank statement
(If you have a bank account)
*If these are available, they must be produced for your application to move on to the next stage.
14. How did you find out about the ‘Your Say, Your Way’ funding opportunity?
Local Press: Community Group: Community Centre staff:
‘Your Say, Your Way’ invitation letter: Applied in another ward previously:
Area Committee/ Area Board:
Other: (please specify)
Please complete the following for contact on matters involving this application:
First Name: Surname:
Home number: Mobile number:
Fax number:
Address:
Postcode:
Email:
*Please write this very clearly
Signature: ______Date: ______
Where possible, please email your application to :-
Postal address :-Gary J. Roberts
Area Boards Support Manager
Chief Executive’s Department
Town Hall Annexe
Town Hall
Luton
LU1 2BQ