Larbert, Stenhousemuir and Torwood Community Council

Todhill Windfarm Fund - Micro Grants Application Form

·  The Community Council is running a micro grants programme with funding from the Todhill (Larbert, Stenhousemuir & Torwood) Community Fund.

·  We have £1500 available to distribute each year to individuals and to groups which do not have a constitution.

·  You can apply for any amount up to £250.

·  Applications can be made at any time.

·  Decisions will be made by the Community Council and will be final.

Please supply us with the following details:

Name of group or individual applying:
Main contact person:
Address:
Postcode:
E-mail:
Telephone (main):

About you and / or your organisation (please tick one box below):

I am applying as an individual
I am applying on behalf of an unconstituted group


If you have ticked “unconstituted group”, please explain the main purpose of the group and your role with the group:

Details of Micro-Grant Requested:

Please provide details of your project – what activities will you carry out and who will benefit?

How much are you requesting? (Up to £250)______

What will the micro-grant be used to pay for? (Please provide a cost breakdown)

Your project must meet one or more of themes which emerged from the Larbert, Stenhousemuir and Torwood Community Plan. Please tick which theme(s) apply to your project:

Improvesthe physical appearance of our community (including the towncentre) and makesbetter use of our public spaces
Developsour community services, events and facilities to better meet the diverse needs of local people
Preservesand enhancesthe natural environment for the benefit of those who live in the area
Buildsthe skills, capacity and sustainability of our communityorganisations

Declaration: I certify that the information contained in this application is correct, and that I am authorised to make the application on behalf of the above group / individual.

Name (please print): ______

Signature: ______

Date: ______

Data Protection Statement

Any personal information you give to us will be processed in accordance with the UK Data Protection Act 1998. Larbert, Stenhousemuir & Torwood Community Council will use the information which you give will be used for the following purposes: to enable the Community Council to create a computer and paper record of your micro-grant fund application; to enable the application to be processed and assess by the Community Council; and to enable the Community Council to compile statistics to report on the performance of the Fund to Foundation Scotland. We will publish information on the names of individuals who have been granted funding, purpose of funding and the amount awarded through the Micro-Grant Fund. The detailed information on your application will be kept securely, and will be kept no longer than necessary.

Please send your completed applications to Larbert, Stenhousemuir & Torwood Community Council as follows:

The Secretary

Larbert, Stenhousemuir & Torwood Community Council

C/o 92 Stirling Road

Larbert

FK5 4NF

Or by e-mail: