MINIBUS APPLICATION FORM
Please return your completed form to:
Any attachments that cannot be sent by email must be sent to:
Grants Executive, Lord’s Taverners, 90 Chancery Lane, London, WC2A 1EU
Before you complete your application, please visit our website www.lordstaverners.org and consider the following:
Lord’ Taverners mission is to enhance the lives of disadvantaged and disabled young people through sport and recreation. Our programmes support some of the most marginalised and at risk young people in the UK. We create a range of opportunities for young people from deprived areas and those with disabilities to engage in sport and recreational activities in their local communities.
1. Lord's Taverners minibuses are based on the current Ford Transit model, with a diesel engine. The average cost to the charity of an accessible minibus is £52,500. The minibuses are painted in the Lord's Taverners Meadow Green and are branded with our livery, which must remain on the vehicle at all times.
2. All approved applicants are required to pay a self-help contribution towards the minibus, the cost of which is dependent on the type of minibus and waiting list required (please see Section 4).
3. All applications must be typed or clearly written.
4. Applications will be considered from schools/ organisations that cater for young people under the age of 25 who have a physical/ sensory/ learning disability. We are unable to support schools that cater for socially disadvantaged children or mainstream schools for children with behavioural problems. Please refer to the Disability Discrimination Act 2010 if you are unsure whether you meet our criteria.
5. All sections must be completed with as much relevant detail as necessary.
6. Any incomplete application will be automatically rejected.
7. Our vehicles are registered as Disabled Passenger Class and are exempt from VAT and road fund licence. When the vehicle is in use there must be a proportion of passengers with a disability travelling at all times. If not, then you may be in breach of the legal requirements set by DVLA for this type of vehicle. In addition your insurance may be invalidated. Recipients of Lord's Taverners minibuses are not permitted to change the vehicle classification (shown on the log book) without prior notification and approval from the Lord's Taverners.
8. We will require all recipients of our minibuses to be involved in a local PR presentation which may take place at the location of the minibus or at one of our regional events.
9. All recipients of our minibuses must agree to complete a short evaluation questionnaire to provide us with feedback and to enable us to improve the services we offer. In addition you may be asked to provide ongoing evaluation information which could be questionnaires, short interviews with staff or other beneficiaries/ stakeholders or other information.
10. All recipients of our funding will need to provide a copy of their “Children, Young People and Vulnerable Adults Protection and Safeguarding Policy”.
11. Please note: If your self-help donation is provided by a third party they do not automatically receive the right to have their logo displayed on the vehicle. This is done at the sole discretion of the Lord’s Taverners. If we find you have added additional logos after delivery of the vehicle you will be asked to remove them.
12. The organisation must only use the minibus for the stated purposes. If this is not the case, or in the event of misuse, winding up or bankruptcy within five years of taking possession of the vehicle, title of the minibus will automatically revert to the Lord's Taverners.
13. It is the duty of the recipient organisation to ensure that all drivers hold the required licence. To ensure you are fully aware of the licence requirements please visit the following site: www.direct.gov.uk/driving or refer to the ‘BVRLA Guide to Driving a Minibus in the UK and abroad’.
MINIBUS APPLICATION FORM
Please return your completed form to:
Before emailing the application form please ensure:
· A copy of your “Children, Young People and Vulnerable Adults Protection and Safeguarding Policy” is included
· A timetable of activities as indicated in Section 5 is included
· A set of your latest annual accounts are included
· ALL SECTIONS OF THE APPLICATION FORM ARE COMPLETED
The questions in this application form allow us to gather information we need to decide whether to fund your project.
Lord’s Taverners give minibuses to provide vital mobility for youngsters with special needs and or a disability to enable them to engage and participate in sporting activities. Each minibus is custom designed and costs in the region of £52,500. Strict policy guidelines apply regarding the allocation and award of a minibus so please read these carefully. Each case is considered individually by the Lord’s Taverners Charitable Programmes Committee who meets quarterly.
Please write clearly in block capitals using black ink or type
SECTION 1 – Contact details of Organisation who will use the minibusName of Organisation who will use the minibus:
Address of Project:
Postcode: / Correspondence Address if different:
Postcode:
Name of Correspondent: / Position:
Telephone Day: Direct Line / Fax:
Mobile: / Email Address:
Website address: / OFSTED link:
Registered Charity Yes / No / Registration Number:
Date established:
SECTION 2 – About the Project who will use the minibus
Please give a brief description of the work carried out by the school / organisation:
How many children are in your care? / How many: Male? Female?
How many are wheelchair users? / How many children have a disability?
Please list the types of disabilities with approximate % breakdown:
Approximate % of children in each age range: / 0 – 11 yrs % / 12 – 18 yrs % / 18 – 25 yrs % / 25+ yrs %
Will these numbers increase in the next 12 months? Yes / No / If yes by how many:
What is the average staff/children ratio? / Is your school a fee paying/privately funded school or a state run provision?
How many children will benefit from funding from the Lord’s Taverners?
SECTION 3 – Existing Transport
Have you previously owned a Lord’s Taverners minibus? Yes / No / If Yes – when did you receive it?
Is this application to: please tick
Replace an existing Lord’s Taverners minibus ( )
Replace a minibus not supplied by Lord’s Taverners ( )
Increase your current fleet of minibuses ( )
You currently do not have a minibus ( ) / Why do you need to change an existing vehicle/increase your fleet?
How many minibuses do you operate?
When was the minibus you are seeking to replace registered?
What is the mileage of the minibus you are seeking to replace? / Miles
What is the make / model of the vehicle you are replacing?
If the children are not resident how do they get to you?
SECTION 4 – Self Help Contribution and Type of Minibus Required
Details of the minibuses offered by the Lord’s Taverners are shown below. All applicants are required to pay a self-help contribution towards the minibus, the cost of which is dependent on the type of minibus required.
Lord’s Taverners cannot guarantee the delivery period which is dependent upon the availability of vehicles from our supplier and funds available from the Charity..
Currently our standard waiting list is 18 months long and our Fast Track waiting list is approximately 9 months from the date the application is approved. Please tick your preferred choice:
Standard minibuses:Ford Transit 15 Seater ( )
Ford Transit 17 Seater ( ) / Standard List
£14,000 ( ) / Fast Track
£21,000 ( )
Wheelchair accessible minibuses - provided with semi-automatic under floor tail lift and removable seats:
Ford Transit 16 Seater ( ) / Standard List
£17,000 ( ) / Fast Track
£28,000 ( )
Do you have your self-help in place? Yes / No / If no, when would you anticipate this being available?
Please provide details of your fundraising activities:
Have you approached your Local Authority or applied to another source for assistance with a minibus? If yes please give details, including date of application and outcome:
Please note : In order to drive a 15 seat or 17 seat standard minibus (without a tail-lift) or 16 seat wheelchair accessible minibus drivers must have passed their driving test before 1st January 1997 or be in possession of a D1 category licence. For further information please refer to www.direct.gov.uk/driving
SECTION 5 – Use of Minibus
Please explain why you need a new minibus and how it will be used:
How will a minibus from the Lord’s Taverners make a difference to your pupils/ clients?
Please set out what activities you will be able to do that you are currently unable to do without a Lord’s Taverners minibus? It would assist us if you could provide a timetable of activities annotated with where our minibus would be used for current or additional activities
What do you anticipate will the positive outcomes of a minibus from the Lord’s Taverners?
What would be the consequence of not having a Lord’s Taverners minibus?
How many days per week will the minibus be used? / What is your estimated annual mileage?
Will any other group use the minibus? Yes / No / If Yes, who, how often and for what purpose?
Do they pay to use the vehicle?
Are you able to provide qualified drivers? Yes / No / Can you keep the vehicle taxed and insured? Yes / No
Will the vehicle be kept in a secure place? Yes / No / Do you have funds to service and maintain minibus? Yes / No
Can you ensure the original artwork is not defaced, added to or changed in any way and will be replaced following any bodywork repairs? Yes / No / Can you ensure that the minibus will principally be used by young people under 25 years with a disability and their carers? Yes / No
SECTION 6 – General
How did you hear about the Lord’s Taverners?
Have received support previously: Yes / No / Website Yes / No / Event: Yes / No
Organisation: Yes / No / Word of mouth: Yes / No / Member Yes / No
Have you applied to the Lord’s Taverners before? Yes / No / Was your application successful Yes / No
If Yes, what was the date(s) of your application(s)? / How much did you receive?
For what purpose was the grant(s) awarded?
What have the principal benefits of our previous funding been for your organisation?
Are you aware of other areas that we support:
Sensory & Outdoor Equipment: Yes / No / Sports Wheelchairs: Yes / No
Table Cricket Competition: Yes / No / Boccia Competition Yes / No
Please note you can apply for funding from more than one area of our giving. Details of our guidelines and applications can be found within the Charity section of our website www.lordstaverners.org
SECTION 7 –– Accounts
Please provide the following details from your most recent annual accounts:
Account year ending : day/month/year
Total (gross) income / £
Total Expenditure / £
Balance at end of year / £
Savings (reserves, cash, investments) / £
Please provide some background on your balance and savings and how you intend to use these:
Please note: If your self-help donation is provided by a third party they do not automatically receive the right to have their logo displayed on the vehicle. This is done at the sole discretion of The Lord’s Taverners. You will be asked to remove any additional logos added after delivery of the vehicle.
SECTION 8 – Confirmation and SignaturePlease supply a set of your latest annual accounts. Please provide any additional information to support your application on a separate sheet.
We hereby agree that to our knowledge the above and attached information is correct and that we adhere to the guidelines set out by the Lord’s Taverners.
All vehicles supplied by the Lord’s Taverners are built to manufacturer’s specifications as disabled passenger carrying vehicles and are registered as such. The minibuses must be used for carrying passengers with disabilities at all times. Government Transport Regulations prohibit the use of these vehicles for carrying passengers for hire or reward. If they are deemed to be used in this way you may be liable for prosecution. You may also be uninsured.
The organisation must only use the minibus for the stated purposes. If this is not the case, or in the event of winding up or bankruptcy within five years of taking possession of the vehicle, title of the minibus will automatically revert to the Lord's Taverners.
Please provide two signatures (Headteacher/Head of Trustees/Head of Governors/CEO etc)
Signature: / Position Held:Print Name: / Date:
Signature: / Position Held:
Print Name: / Date:
PLEASE ENSURE THAT YOU SUBMIT YOUR APPLICATION ELECTRONICALLY
Registered Charity: 306054 / Company Number: 582579
Updated: October 2016
MINIBUS SPECIFICATIONS AND DIMENSIONS
15 Seat Factory MinibusModel: Ford Transit 15 seat factory minibus.
L3 H2 Model
Engine: Euro 6 125 PS
Colour: Green with Lord’s Taverners branding
Modifications:
Speed limiter, rear view lens, electric side step, reverse alarm, head bump pads at side and rear entrances, school signs, side entrance grab handle. Automatic Fire extinguisher in engine compartment.
Dimensions:
Length: 5981mm
Height: 2514mm
Width: 2474mm
Weight: 4100 KG
All seats are M2 tested & fitted with lap/diagonal belts.
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17 Seat Factory Minibus
Model: Ford Transit 17 seat factory minibus.
L4 H3 Model
Engine: Euro 6 125 PS
Colour: Green with Lord’s Taverners branding
Modifications:
Speed limiter, rear view lens, electric side step, reverse alarm, head bump pads at side and rear entrances, school signs, side entrance grab handle. Automatic fire extinguisher in engine compartment.
Dimensions:
Length: 6704mm
Height: 2763mm
Width: 2474mm
Weight: 4600 KG
All seats are M2 tested & fitted with lap/diagonal belts.
16 Seat Wheelchair Accessible
Model: Ford Transit 460 long wheel base jumbo van at 4.25 tonne.
Engine: Euro 6 125 PS
Colour: Green with Lord’s Taverners branding.
Conversions:
16 seat accessible minibus (including driver )
With M2 floor suitable to carry a maximum of three wheelchairs.
Vehicle fitted with Ratcliff Palfinger under floor automatic hydraulic tail-lift and school signs
Vehicle supplied with three sets of straps and three sets of double reel inertia wheelchair occupant harnesses.
Dimensions:
Length: 6704mm
Height: 2763mm
Width: 2474mm
Weight: 4250 KG
All seats are M2 tested & fitted with lap/diagonal belts. /
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