South Gloucestershire Council
Safer & Stronger Community Groups Initiative (SSCIF)
Funding Application Form
(2013/14)
APPLICANT (Managing the project & funds).Each section of the application must be completed fully.
Name of Organisation:Main Contact Name:
Role/Job Title:
Contact Address:
Postcode:
Telephone No: / Email:
Governance Arrangements: Does the organisation have a formal constitution? / Yes/No
If No, are you willing to adhere to the policy statement set out by South Gloucestershire Council
Yes/No
Does the organisation have an Equalities Policy which is implemented in its actions? / Yes/No
If No, are you willing to adhere to the policy statement set out by South Gloucestershire Council
("This group/project is committed to working in a way which values and treats all people with respect and dignity, and celebrates diversity. The group/project, through it's practices, will ensure that no member, service, user, employee, volunteer or job applicant will receive less favourable treatment or suffer unlawful discrimination on the grounds of age, colour, impairment, marital status, lifestyle and culture, nationality, race, gender or sexuality, or on thegrounds of economic or social status.")
Yes/No
Does your project work with specific vulnerable groups? / Yes/No
Complete if appropriate:
Children & Young People – Yes/No
Vulnerable Adults - Yes/No
If Yes please providecopies of the appropriate policiesthatare implemented in the organisations actions (Model policies can be made available if you do not currently have one).
PROJECT
Project/Activity Title:Brief description of Project/Activity:
Outcomes to be achieved by the Project/Activity:
Safer Stronger Community Group:
Local priority/issue the project addresses:When was the application discussed and approved by a formal SSCG meeting?
Please explain how you will make your project accessible to all members of your community (Equalities/diversity)
Other Agencies Involved:(list all the other agencies, voluntary organisations, community groups who will be involved in delivering the outcomes)
Proposed Project Start Date: Proposed Project End Date:
Total Project Cost
……………………………………………………………… £
……………………………………………………………… £
……………………………………………………………… £
Have you already raised or received monies from any other source towards the project? (What matched funding can you already provide)
……………………………………………………………… £
……………………………………………………………… £
……………………………………………………………… £
How will the SSCIF funding be spent?
*TOTAL FUNDING REQUEST FROM SSCIF = £ ______
I certify this application is a true and accurate description.
Position in applicant organisation: ______
Please print name:______
Proposal signed by: ______
Date: ______
Payment Details
If your organisation is awarded a Safer & Stronger Communities Initiative Fund Grant, South Gloucestershire Council will normally transfer the money direct to your bank account using the Bankers Automated Credit System (BACS).
The BACS system is quicker and more secure; you will receive by post a remittance advice slip advising you when the payment will be made.
To ensure swift payment of your grant please provide us with the following information as appropriate.
Name of Group/Organisation
This needs to be as it appears on the bank account and to which payment will be made
Bank Account Number
Bank Sort Code Number
Name of Bank or Building Society and Branch Name
Building Society Roll Number (if applicable)
Please note: These details will be held securely on our database for payment purposes only.
Please return your completed applicationto: by:
Phase One: Monday 29th April 2013
Phase Two: Monday 16th September 2013
For anyone who is unable to complete an electronic application, hard copies can be forwarded to the address below.
For the attention of: Phillip Maswera
Grants & Funding Officer
South Gloucestershire Council
Safer & Stronger Communities
PO Box 2078
Thornbury
BS35 9BJ
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