Please note:This is a template for your application preparation only.

Please do not submit this form as your application- you must complete the online application form (via the link provided to your personal email).

If you submit this document as an application it will be deemed invalid.

Community-led Buildings Programme

Project SupportGrant Application Form

This grant is intended to help groups pay for the work needed to move their Community Buildings project to the point of submitting a Community Right to Build Order. (In the case of community-ledhousing groups, this could alternatively permission application)

To apply, you should be either:

a) a qualifying body intending to construct, rebuild or extend community buildings (including community led housing) with the aid of a Community Right to Build Order,

OR

b) a community led housing project intending to apply for a traditional planning permission.

Before completing this application form, please read the guidance designed to help you. You can find this at

If you have questions about this form, or if you have particular communication needs, please contact us on 0300 020 1864

Please answer all the questions on the application form.

Please only apply for grant which can be spent before 31st March 2016. Under no circumstances can spending from this grant take place later than 31 March 2016 and any underspend must be returned to Groundwork UK as part of the monitoring procedures.

Organisation Details

1.

*Address: No and Street
Town
County
* Postcode
Website Address

2.* Please provide us with the name, phone number and email address of an alternative contact.

This person will be contacted about the application if we cannot get hold of the main applicant

3.* Please state the legal status of your organisation.

□ / Company Limited by Guarantee
□ / Unincorporated Association
□ / Friendly Society
□ / Mutual Provident Society
□ / Industrial and Provident Society
□ / Trust
□ / Community Interest Company (CIC)
□ / Charitable Incorporated Organisation
□ / Parish Council
□ / Town Council

4.Registered Charity number (if applicable)

5.Company number (if applicable)

6.Date your organisation was incorporated (if applicable)

DD / MM / YYYY

7.* Are you VAT Registered?

□ / Yes
□ / No

* Please tell us your VAT number

Demographic Information

Which Region and Local Authority is your project located in?

8.* Region

Local Authority
□ / East of England
□ / East Midlands
□ / Greater London
□ / North East
□ / North West
□ / South East England
□ / South West England
□ / West Midlands
□ / Yorkshire and Humber

9.If you are working across boundaries or located in a national park please name the additional local planning authorities below.

Local Authority

10.* Please tell us what type of area you live in.

□ / Urban
□ / Rural
□ / Mixed urban/rural
□ / Coastal
□ / Suburb
□ / Inner City
□ / Market Town

11.* Ward Area Name(s)

12.* Approximate population size of the ward where your project is located:

13.* Having looked at the link from the help text below, in terms of the level of deprivation, please tell us the percentage band your area falls into.

To calculate the percentage of deprivation in your area please click on this link

□ / 20% or less (shows an area with the least amount of deprivation)
□ / 21% - 40%
□ / 41% - 60%
□ / 61%-80%
□ / 81% - 100% (shows an area with the most amount of deprivation)

14.* Does the Local Authority have an up to date adopted local plan?

The Local Plan is the name for the collection of documents prepared by your Local Planning Authority for the future development of the local area.

You can find out if your Local Planning Authority has an up to date adopted Local Plan by speaking to them directly. You can find out the contact following link into your browser

□ / Yes
□ / No

About your project

15.* Which of the following applies to your project?

□ / a project to construct, rebuild or extend community buildings or community led housing, with the aid of a Community Right to Build Order
□ / a community led housing project intending to apply for a traditional planning permission.

16.* What is your project called?

17.* What are you planning to build?

□ / Homes
□ / Community Hall
□ / Community Pub
□ / Other
If applicable, please specify "Other":

18.Please explain your project

19.If your project includes housing please state the number and type of units.

Number of housing units
Type of housing units

20.* Why is the grant needed?

21.* How will your project benefit the community and meet its needs?

Answers should include a descriptions of needs; a description of the target group of residents who will benefit from the completion of the project; how many people will benefit from it, and in what way.

22.* Describe any community engagement completed or planned.

23.* Please tell us about the evidence you have that the community supports your proposal.

24.* Is your project in a Neighbourhood Plan area?

□ / Yes
□ / No

If yes, please give its name and explain any fit or conflict between your project and the Neighbourhood Plan.

25.* Is the site in a Designated Neighbourhood Area?

□ / Yes
□ / No

26.* Who owns the site?

27.* What is the address of the site and what is its current use and condition?

28.* Are there any restrictions on the use of the land for the proposed site?

For example, planning covenants, listed building status, environmental projection, site contamination etc.

□ / Yes
□ / No

*If yes, please specify

29.* Do you have a secure interest in the site?

□ / Yes
□ / No

* Please explain the nature of your secure interest or any plans you have to gain a secure interest.

For example, lease/buy etc and state whether you have reached agreement with the landowner.

How much will your project cost?

30.* How much will it cost to complete your building project in total?

Please ensure you supply a full project budget that reflects the figure shown here.

£

31.* How do you plan to fund the project in total?

£

32.* How much will it cost to develop your proposal to the point of submitting a Community Right to Build Order? (In the case of a community led housing project, this could alternatively be to the point of submitting a traditional planning application)

£

33.* How much are you applying for from this grant programme?

£

34.Please explain how you will fund any difference between the amounts shown in q.31 and 32.

.

35.* As outlined in the application guidance, it is expected that applicants will raise at least 10% of the amount you are applying for in this application. Please enter the amount that corresponds to the 10% of the total amount you are applying for in this application.

36.*Please explain how you will raise this 10% contribution

Budget Breakdown

Please show how you will use the monies for which you are applying. Please state day rates of suppliers as well as overall costs. If you need more space, please supply further detail as part of the attached documents with your application.

Item / * Type of Activity / *Supplier and day rate / * Cost / Start date / Completion date
1 / £ / DD MM YYYY / DD MM YYYY
2 / £ / DD MM YYYY / DD MM YYYY
3 / £ / DD MM YYYY / DD MM YYYY
4 / £ / DD MM YYYY / DD MM YYYY
5 / £ / DD MM YYYY / DD MM YYYY

37.Please explain why you have chosen your suppliers and the skills they have.

Background and track record

38.* Please describe the track record of your organisation and give evidence of local connections and partnerships

39.* Referring to the help text below, please confirm that your organisation meets the criteria of a qualifying body.

A qualifying community group must be a body corporate established to further the social, economic and environmental well-being of people living, or wanting to live, in a particular area.

The organisation must have at least 10 members living in different dwellings in the particular area. Individuals who live or work in that area must be entitled to become voting members of the community organisation and be able to exert control of the organisation through a majority of voting rights and places on the board or governing body.

Any profits generated may only be used to benefit that community. Assets may not be disposed of, improved or developed except to benefit the community, and in the event of winding up the organisation, assets must be transferred to another body corporate with similar objectives. Parish Councils are qualifying groups.

40.* Does your organisation have an active management committee/board of at least three people who are unrelated?

□ / Yes
□ / No

41.* Does your organisation have a bank account in the name of your organisation, with at least two unrelated signatories?

□ / Yes
□ / No

42.* Please describe your financial management controls

43.* Who would be responsible for project managing the grant within your organisation and ensuring that all terms and conditions are met?

44.* How much do you hold in your reserves?

£

If you have reserves, please explain why you are not using this money to fund this project.

45.* How many paid employees work within your organisation?

46.* How many volunteers work within your organisation?

47.* Please describe the key skills and experience of your Trustees or Board and Senior Management Team.

48.* Have you received any other grants towards this project to date?

□ / Yes
□ / No

* If yes, please state what they are and their value.

49.* Please ensure you upload the following documents with your application:

Last set of accounts

Governing documents (e.g. your constitution or memorandum and articles of association)

A full project budget

Supplier quotes

Please ensure that this is a single pdf document that includes all this information and that the document size is no larger than 5mb.

Declaration

TERMS: By submitting information via this web form you agree:

I certify that the information contained in this form is true and correct, that I have the authority to act on behalf of the organisation and that this proposal has been approved by the Trustees / Directors.

That Locality and our partners in the Community Buildings Grant Programme may use the data you have provided. Wherever your personal information may be held by us, we will take reasonable and appropriate steps to ensure the information you share with us is protected from unauthorised access or disclosure. If you are a member of Locality we may pass your details to selected third party organisations who we believe you will be interested in hearing from. These third parties are obliged to keep your details securely, will use them only to fulfil the request and will dispose of the details when the request is complete. If you would like to discuss how your information is stored and used by Locality and our partners in the Community Buildings Programme please contact .

□ / I confirm * I have read and agree to the terms of this web form submission

Locality and our partners in the Community Buildings Programme may contact you to obtain feedback on the support you have received from the programme. You will receive news and updates and may also be invited to future events from Locality and our partners in the Community Buildings Programme.

Please note, if you opt out of all Locality mailings you will no longer be able to receive mailings that you have previously subscribed to, including member mailings. To discuss your mailing requirements with our team contact .

□ / To opt out of all Locality mailings tick here

Please do not press the submit button unless you are ready to submit your complete application.

Just close the window if you wish to come back to this survey at any point. When you revisit the link, remember to press next on each page where you make changes to ensure updates are saved.

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CB Project Support Grant Application Form 2015-18

Blank Application Form