DCU - CLC

CLUB LIFE COMMITTEE

GRANT APPLICATION FORM 2014/2015

Club Name:______

Club Email Address:______

CONTENTS
/
1. Committee
/
8. Intervarsities
2. Affiliation
/
9. External Facility Hire
3. Banking Details
/
10. Capital Equipment
4. Membership
/
11. Coaching
5. Sponsorship
/
12. Community Projects
6. Safety Arrangements
/
13. Summary
7. Competitive Fixtures
/

SECTION 1 - COMMITTEE

CLUB COMMITTEE MEMBERS (Must be a student)

TITLE / NAME / EMAIL / CONTACT NO. / STUDENT NO.
Chairperson
Secretary
Treasurer
PRO
Safety Officer
Equip. Manager
President
(must be staff member)
CLC Rep

N.B.Please note that the President must be a member of staff.

Please note that the above information will be released to those enquiring about your club. If you do not want the information released please indicate by placing an asterix next to the name.

SECTION 2 -AFFILIATION

Please list all organisations the club is affiliated with.

Governing Body / Affiliation Fee / Is Insurance included? / Is Affiliation compulsory?
1
2
3
4

Please Note: If Affiliation is per person, please submit details of amount per person and number of members to be affiliated.

Are Club members insured by the Governing Body above? Yes/No

If Yes, please attach details of cover provided.

If No, please indicate if the club takes out any insurance cover in addition to the DCU Accidental Bodily Injury Insurance Yes/No

INSURANCE(Is Insurance Optional or Compulsory)

COMPANY NAME / DETAILS PER PERSON / TOTAL
3. - BANKING DETAILS
Account Name / Account No. / Balance / Names of Signatories

You must attach (or submit to Siobhan Byrne) a copy of a your most current bank statement. Applications that do not have a statement attached (or have not been submitted) will not be considered.

NB: You must have at least three signatories one of which must be the Club Treasurer.

SECTION 4 - MEMBERSHIP

Number of paid up members ______x €4.00 =€______

Total income from members €______

These figures should be as of the date of submission of Grant Application Form.

SECTION 5 – SPONSORSHIP

Please outline below any sponsorship that has been secured for the 2014/2015 academic year

Company Name / Value of sponsorship €’s / Clubs obligation to sponsors eg name on jersey, programmes etc.
1
2
3
4
5

* Include specific event sponsorship in subsequent sections

SECTION 6 - SAFETY ARRANGEMENTS

Please provide details of your clubs Code of Practice for Safety, to include safety statements, risk assessments, emergency procedures, first aid, equipment maintenance or inspection schedules, procedures for inducting novices etc.

Please see the following link or please speak to Yvonne McGowan, Sports Development Officer or Siobhan Byrne, Club/SocDevelopment & Finance Officer.

SECTION 7 – COMPETITIVE FIXTURES

* Copy of proof of competition must be attached or the event will not be considered eg. letter of invitation, entry forms, league schedule etc(Complete Individual Application for each League/Cup Fixture)

Competition
(League/Cup etc.)
Date of competition – NOT dates of trip
Location
Hosting Body
Travel Costs per personOR
Bus Hire Costs (Attach Quote) / €
Proposed number of nights accommodation
No. of people attending
Secured sponsorship

Office Use Only

Total Travel assistance sought €______x No. of people ______=€______

Total Accommodation expenses sought €______x No. of people ______=€______

SECTION 8 – INTERVARSITY EVENT

* Copy of proof of competition must be attached or the event will not be considered eg. letter of invitation, entry forms etc.

Name of Event/Hosting Body
Location
Dates of competition -NOT dates of trip
Entry Fee
(Please provide a detailed breakdown of Entry Fee)
Travel Costs per personOR Bus Hire Costs (Attach Quote)
Proposed number of nights accommodation
Costs per night per person
No. of people attending
Secured sponsorship

Office Use Only

Total Travel assistance sought €______x No. of people ______=€______

Total Accommodation expenses sought€______x No. of people ______=€______

Entry Fee (please provide a detailed breakdown of Entry Fee)€______x No. of people ______=€ ______

SECTION 9 – EXTERNAL FACILITY HIRE

Specifically for: Canoe Club, Swimming Club, Tennis Club, Subaqua Club

Venue
/ Times / How Many Hours / No. of Weeks / Cost Per Hour / Total

PLEASE NOTE:Applications for funding for External Facility Hire for the 2015/16 academic year mustbe submitted in writing to on or before Friday, April 11th 2015.

SECTION 10– CAPITAL EQUIPMENT

ASSETS LISTS

Please list all assets that are valued at €40 or more, which are held by your club

Asset / Stored? / Value / Age / Insured?
1
2
3
4
5
6
7
8
9
10

* If equipment is insured a copy of the policy must be provided to the CLC (Club Life Committee)

APPLICATION FOR THE PURCHASE OF CAPITAL EQUIPMENT

* All requests must be accompanied by at least three independent quotes on company letterhead.

Equipment / Number required / Cost / Total Cost / Office Use
Allocated
1
2
3
4
5
6
7
8
9
10
11

* List items in order of priority.

SECTION 11 – COACHING (Please copy for each additional team)

Please tick relevant box (Paid Coach OR Volunteer Coach)

PAID COACH / VOLUNTEER COACH
Name: / Name:
Coaching Qualification(s)
(Please attach) / Coaching Qualifications (s)
(Please attach)
Email: / Email:
Contact Number: / Contact Number:
Venue: / Venue:
Times: / Times:
Proposed No. of Hours / Proposed No. of Hours
Proposed No. of Weeks / Proposed No. of Weeks
Proposed Cost Per Hour: / € / Proposed Cost Per Hour: / €
Total Requested from CLC: / € / Total Requested from CLC: / €
OFFICE USE ONLY – TOTAL ALLOCATED / € / OFFICE USE ONLY – TOTAL ALLOCATED / €

SECTION 12 – COMMUNITY PROJECTS

In the space below, please provide details of any projects, within the community, that your Club is involved with or proposing to be involved with. The Club Life Committee will be allocating a budget for selected projects.

Details / Cost

SECTION 13 – SUMMARY

ITEM / COST

Affiliation

/ €

Insurance

/ €
Competitive Fixtures / €
Intervarsity Event / €
Capital / €
Coaching / €
Community Projects / €
TOTAL FUNDING APPLIED FOR / €

GRANT APPLICATION CHECKLIST

  1. Most current bank statement attached
  1. Proof of competition details 
  1. Insurance policies for capital equipment
  1. Three quotes for each piece of equipment sought
  1. Coaching Qualifications for all coaches applied for
  1. Current Club Constitution

Please Note: Grant Application forms must be emailed to:

1