Wearmouth Community Development Trust

LegacyFund

Application Form

Please note that this fund is available for organisations whose beneficiaries reside in Sunderland and for projects which alleviatesocial isolation, contribute to health and wellbeing, support children, young people and families, support and strengthen volunteering and bring about significant capacity building initiatives to frontline VCSE organisations.

Please answer every question in this application. There are staff available to assist you in completing this application at Voluntary and Community Action Sunderland (VCAS). Do contact us if there is anything you do not understand. (Details are on the rear of this application)

Q1. Contact Details

Q1

Q2. First Contact person

Someone in your organisation who can discuss this application, and who we can contact during office hours.

Name
Position in group
Daytime phone number Evening phone number
Email address

Q3. Alternative contact person

Please give an alternative person in case the first person is not available

Name
Position in group
Daytime phone number Evening phone number
Email address

YOUR GROUP OR ORGANISATION

Q4. What type of organisation are you?

Q5. Does your group employ staff?

Q6. How many people are involved in running your group?

MManagement Committee members

Q7. When did your group start?

Q8. In which area of the North of the City does your group do all or most of your work?

Monkwearmouth, Town End Farm, Fulwell, Redby, Southwick, Downhill, Witherwack, Seaburn, Marley Potts, Carley Hill, Hylton Castle, Castle Town, Roker, and St Peters.

Q9. What does your group or organisation do, and how many people take part in your group’s activities each year? (Please use an additional sheet if necessary)

Q 10. What was your organisation’s income / expenditure in the last three years?

Financial Year / £ Income / £ Expenditure

THE PROJECT YOU ARE APPLYING FOR

Q 11a. What it the name of your project?

Q11b. If you are successful when will the grant be used?

Q12. Describe the project or activity you want the grant for

ant the grant for

Q 13. Why is the project needed, and how many people will benefit?

Q 14. How will you know if the grant has been a success?

Q 15. How much will the project or activity cost in total?

Q 16. Breakdown of the costs

Please list all capital expenditure items (equipment/goods etc.) separately.

Item / Total Cost £ / Request to Small Grant £
Grand Totals

Q 17. If you are not applying to this fund for all you’re funding for this project or activity – Please state.

Funding Source / Amount £ / Is this funding confirmed?
□Yes
□No
□Yes
□No
□Yes
□No

THINGS WE NEED TO KNOW

Q 18. Your bank account

Q 19. Where did you learn about the Grant Scheme?

Q 20. Contact details for someone who is willing to be an independent referee for your application if we wish to contact them.

Name
Address
Post Code
Telephone
Email

Q 21. Have you used the services of VCAS to help you with this application?

DECLARATION

  1. I am authorised to make this application on behalf of the organisation
  2. I certify that the information in this application is correct
  3. If the information in this application changes in any way I will inform VCAS
  4. I give permission for VCAS to record details of my organisation electronically and any organisation who work with VCAS to assess applications and to monitor and support projects, and to contact my organisation by phone, mail or email with information about its activities and about funding opportunities.
  5. I certify my group/ organisation have a signed constitution.
  6. I certify that, two or more signatories required to sign for expenditure for our organisation.

Along with your application you will need to send the following documentation:

  1. A copy of your governing document
  2. A copy of your latest agreed annual accounts
  3. Any printed quotations for items of capital

Send your completed application to the Voluntary and Community Action Sunderland. Please remember to include your supporting documentation.

Voluntary and Community Action Sunderland (VCAS) / 8 Frederick Street
Sunderland
SR1 1NA / Tel: 0191 565 1566
Email:

You can email your application as long as you can attach all the relevant documents

PLEASE KEEP A COPY OF THIS COMPLETED APPLICATION

AND ALL SUPPORTING PAPERWORK