Application Form
Community Projects /
For office use only / Date received:
Date acknowledged:
Reference:
Please note there is a separate form for Community Events
Pleaseensure you have read andunderstoodthe notes; ‘GuidetotheCriteria, ApplicationProcessandConditionsofFunding’and‘Guideto CompletinganSKDC CommunityFundApplicationForm’before completingthisform.Important, pleasenote:
Yourgroupmusthaveitsown bankaccountandconstitution orgoverningdocument.
- Youwillneedat least20%matchfunding (see 6c).
- You must provideall supportingdocumentswithyourapplication (seesection9)
- Grantsarepaid75%inadvanceand 25%on completion.
All sections must be completed
Ifyourequirehelpcompletingthisform (especiallyifyouare asmallgroup)oracopyin an alternativeformat or language, pleasecontact Lincolnshire CVS on Tel:01205 510888 (select option 4 – Grantham office) or Email:
Section 1. Contact Details
1a.Nameof group/organisation
1b.Contactname
1c.Contactaddress
1d.Postcode
1e.Daytimetelephonenumber
1f. Mobilenumber
1g.Email
1h.Your positioninthegroup
Section 2.AboutyourGroup/Organisation
2a. Whatyearwas yourgroup/organisationformed?
2b. Websiteaddressofyourgroup/organisation
(ifyouhave one)
2c.Pleasegive abriefdescriptionofyourgroup/organisation
(whattypeofgroupare you,whatareyouraimsandwhatdo youdo?)
2d.CharityRegistrationNumber (if applicable)
2e.Howmanytrustees do you have?
2f. How many members ofthemanagement committeedo youhave?
2g. Howmanyvolunteers do youhave?
2h.Howmanypaidstaffdoyou have? (fulltime=1,halfpost = 0.5)
2i.Detailsof twobank/building society signatories that are unrelated.
Nameofsignatory1: / Addressofsignatory 1:
Nameofsignatory2: / Addressofsignatory 2:
Section 3:YourProjectProposal
3a.Nameofyourproject
3b.Categoryofgrant applying for (Refer tosection 2 of‘Guide tothe Criteria,Application Process andConditionsofFunding’) / Category / (tick oneboxonly)
Community Amenities
Community Buildings
Community Enterprise
SupportingCommunities
3c.Locationof project(includingpostcode)Thelocationofyourproject mustbe withinSKDC district.
3d. Whichgeographicalareaswill benefit from yourproject?
3e. What project/activities doyouwantusto helpfund?Bespecificaboutwhatyouwilldo,howyouwill do it(includinganyvoluntary input)andwhatyouwould spend thegrant on.
Maximumwords400
3f. Howwillyourprojectbenefit thelocal community?Forexample;increasedvolunteeringandparticipation,reducedrural isolation.
Maximumwords200
3g. What evidence do youhave to showthat yourproject isneededandwillcontributetolocalprioritiesin yourarea?Forexample:CommunityLedPlans, questionnairesorlettersofsupport.
Maximumwords200
3h.Howwillyoumeasurethe differenceyourprojectwillmake?Forexample;increasednumbersusinganimprovedvillagehall or reductioninbillsdueto energyefficiencymeasures.
Maximumwords200
Section 4 - ProjectPlanner
4a.Project startdate: / 4b.Projectcompletiondate:
(no later than 2 years after award date)
4c.Project timetable -pleaseprovidedetailsof project milestones,suchas;permissionsinplace,purchaseofpropertyorequipment, workscompleted.
Projectmilestone: / Date:
4d.Doesyourproject require anypermissions beforeitcanstart? / Yes / No
4e. Ifyourprojectrequirespermissionsbeforeitcanstart,pleaseprovidedetails.
4f-4i. Doyou ownthepremises/site oftheproject / Yes / No
- If Yes, do you have Freehold - leasehold
- IfLeasehold who owns the lease?
- how long is remaining on the lease?
- If you do not own the premises do you have a rental contract?
- If yes, how long is it for? What is the notice period?
Years / No
Months
4j.How will the ongoingmaintenanceofyourprojectbe sustained andfunded
followingitscompletion?
Maximumwords200
Section 5:Contribution toSouth Kesteven District Council’sPriorities
Pleaseprovidedetailsofhowyourproject meetsat least oneofthe Council’s Prioritiesbelow(you do not needtocompleteall four categories).
5a.Grow the economy:
5b. Keep SK clean, green and healthy:
5c.Promote leisure, arts and culture:
5d. Support good housing for all:
Section 6 -FinancingYourProject
6a. Whatisthetotal costofyourproject(includingVAT)? / £
6b.Howmuchfundingare youapplyingforfromtheSKDCCommunityFund?There is aminimum grant level of£500and amaximumof£10,000 / £
6c. Whatis yourtotalmatchfundingfrom othersources?(mustbeatleast20%oftotal cost) / £
6d. Is yourorganisationVAT registered? / YesNo
6e.VAT registrationnumber(ifrelevant)
Section 7- ProjectBudget (If cheapest quote not chosen please state why under item description)
7a.ProjectedExpenditure
ItemDescription / CostexcludingVAT / VAT / TotalincludingVAT
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
£ / £ / £
Total / £ / £ / £
7b.ProjectedIncome(totalprojectedexpenditureandtotalprojectedincomeshould bethesame)
Source of Income / Confirmed? / Amount
Yes / No
SKDCCommunity Fund(maximum80%oftotalcostsIncl VAT) / x / £
Group’s own cash contribution / £
In-kindvolunteer time(calculated at £9.90 per hour) & In-kind materials.
Thiscannot exceed 10%oftotal cost / £
ReclaimableVAT(ifapplicable) / £
Listother grantsor fundersbelow
£
£
£
£
Total / £
Section 8–Equalitiesand Safeguarding – Please enclose/attach your appropriate policies (Lincolnshire CVS can assist with this)
8a.Doesyourgroup/organisationhave an equalopportunities
policyorstatement? Pleaseencloseacopy withthisapplication / Yes No
8b.Doesyourgroup/organisationhave achildprotectionpolicyor
statement?Pleaseenclose a copy withthisapplication / Yes No
8c.Doesyourgroup/organisationhavea safeguardingvulnerable
adult’s policyorstatement?
With this application as per the clauses above please enclose/attach a copy with this application form. / Yes No
8d. What arrangementswillbemadeto ensure equal opportunities within yourproject (such aspeople inwheelchairs, the visually impaired,thehard ofhearing or people onlow incomes?)
8e.Howwillyouactivelyseek to involve aswide a rangeof people aspossiblefrom differentbackgrounds (e.g.gender,agerange,ethnicity,religion,rurallyisolatedetc?)
Section 9: Supporting Documentation Checklist
Pleasesupplyallrequiredsupportingdocumentswhenyousubmityourapplication.Yourapplicationwillnotbe considereduntilyouhavesuppliedall the documentationbelow. / Tick
A copy ofyour most recentadopted annual accounts
please give a reason why you are unable to provide adopted annual accounts
A copy ofyour most recentbankor buildingsocietystatement(not morethanthreemonthsold)–Evidence attached/enclosed.
Copiesoftwowrittenquotations/estimatesforeachitemofexpenditurebetween £50 and £2,500(not morethan six monthsold) – Evidence attached/enclosed.
Copiesofthree writtenquotations/estimates foreachitemofexpenditure above£2,500(not morethan sixmonthsold) – Evidence attached/enclosed.
A copy ofyourconstitution orgoverningdocument–Evidence attached/enclosed.
Application from Parish and Town Councils will need to provide documentary evidence of account balances and level of reserves held.
Parish and Town Council’s will also need to demonstrate they have exhausted prudent levels of reserves (explanation will be required).
Parish and Town Council’s will also have to demonstrate that they will not use the Community Fund to fund business as usual.
-Evidence attached/enclosed.
Evidence of Need Required
Section 10:Declaration
In signingthisdeclaration I agreethat:
1.Ihavefull authorityonbehalfofthegroup/organisation tomakethisapplication.
2.Ihave readandunderstood the‘Guidetothe Criteria,ApplicationProcessandConditionsofFunding’andagreetotheconditionsof funding.
3.Theinformationcontained in thisapplication is correctatthetime ofsubmission
4.Iwillcompleteandreturna ProjectCompletionFormwithin threemonthsofcompletionofourprojectinorder to drawdown thefinal 25%grantpayment.
5.Thegroup/organisation will have appropriateinsurancecoverforthe project.
Signed* / Print name / Positioningroup(chairetc)
Date
*Lincolnshire CVScanaccept atypedsignatureifthe personsigningisthesame personwhosubmitstheapplication byemail. If this person signing the application form is not identifiable by their email address a signed hard copy will be required.
Section 11: Data Protection
Theinformationyouhaveprovided in yourapplicationwillonlybe usedforthe purposes ofconsideringyourgrant application.If yourapplication is successful, thename ofyour group,thelocationoftheproject, amount awarded and asummary ofyourprojectwillappearin apubliccommitteereport andmayalsoappear ontheCouncil’swebsite and inother media.
Wemayoccasionallywish toshareyourcontact detailswithotherlocalcommunitygroups andorganisations andtheymay wish to contact you-can we pass onyourdetails? Yes No
Section 12: ReturningYourApplication
Pleasemake surethatyouhaveenclosed all requiredsupportingdocumentationandthenreturnyourcompletedform to:
Lincolnshire CVS
c/o South Kesteven District Council
St Peter’s Hill
Grantham
NG31 6PZ
Tel:01205 510888 (select option 4 – Grantham office)
Email:
For Office Use Only:
Applicationdeadline / SKDCCommunityPartnershipto assessapplications / Decisiondate(Executive) / Date Grantsawarded
1