Grant application form feb 2011

Ashley, Easton and Lawrence Hill Neighbourhood Partnership

Wellbeing Grant Application Form

1. Does your project work with young people and/or families from the following communities: (tick yes or no as appropriate)

Yes NoAshleyEaston

Lawrence HillYour contact details:

2. Name of your group or organisationContact address: Post code:

Telephone number: Email Address:

Name of the contact person within your group or organisation:

About your group/organisation:3. Please tell us briefly about your group or organisation. (appx 100 words)

4. How are residents of Ashley, Easton & Lawrence Hill involved in your work? (appx 100 words)

1

About your project:5. What is the name of your project?

6. Who is the project aimed at?

7. Please provide a brief description of your project (appx 150 words)

8. What challenge(s) on Stapleton Road does your project address? (Please tick all that apply)

Challenge: Tick belowa) Young people getting involved with/aspiring to street crime.

b) Postcode rivalry and intolerance between communities.

c) Young people not in education, employment or training.

d) Greater understanding by communities and decision makers of the challenges facing young people and how we can work together to give them a better start in life.

e) Lack of trust in the authorities means few people from the communities most affected are influencing decision-making.

f) Damaging the environment through dropping litter and tagging.

9. What method(s) of addressing the challenge does your project use? Please explain below: (list all those that apply)Method: Please Explain:a) Build greater understanding,

teamwork and tolerance between young people and families from communities across the three wards

b) Explore the issues from young people’s perspective with a view to sharing this perspective with the wider community and decision makers.

2

c) Build leadership skills in communities. (young people, parents and family networks)

d) Encourage young people to be part of the democratic life of the city by making their voice heard and shaping the communities they live in, Stapleton Road in particular.

e) Positive role models / Setting an example – how do we as adults, whether we are service providers, neighbours aunts, uncles, teachers, youth workers set an example to young people?

f) Create positive opportunities for young people who hang out on Stapleton Road.

g) Environmental improvements in the Stapleton Road area.

h) Other method(s) used that were not suggested by the Partnership.

10. How will the outcomes of your project impact the challenges young people face on Stapleton Road? (appx 150 words)

11. Please tell us how you are currently involved with the group(s) your project is targeting: (appx 100 words)

3

12. How many people will be directly and indirectly impacted by your project?Directly: Indirectly:

13. How will you make sure your project is of benefit to the relevant equalities communities in the area? (Older people, young people, black and minority ethnic people, lesbian, gay and bisexual people, disabled people, women or other disadvantaged groups)? Please tell us as much as you can – you can attach additional sheets of paper if you need to.

Project activities and timeline:14. Please provide a breakdown of your project’s key activites and deadlines below:Activity Responsible

individual (s)Deadline

15. Please tell us the start date and end date for your project:Start date: End date:

16. Based on the planning you have already done for your project, will you be able to start your project immediately if you receive funding? (tick yes or no)

No Yes

17. If you answered no to question 16, what questions or unknowns do you need to answer before starting your project?

4

Project Budget:18. How much money are you asking for? £

19. Please set out a breakdown of the total costs of your project, showing us which items you are asking us to fund and which are being funded from another source.

Item Cost Please tick if you are asking us to fund this item.

Total CostRequired Documents:

If you have previously submitted an application for a Well-being Grant, please do not assume we have kept copies of your documents on file. You will need to re-

submit them or confirm in advance of the deadline, that we still have copies!

If you do not submit the required documents, your application will be incomplete and will not be considered.

If you would like to apply but need help developing these documents for your group, please let us know and we will do our best to assist you.

You (or your partner organisation) are required to have and submit a copy of the following documents:20. A formal constitution (set of rules for your group)21. An Equal Opportunities Policy22. A Health and Safety Policy

The below documents are requested, but not required unless you answer yes to questions 23 and/or 24. 23. Will your project involve working with children, young people or vulnerable people? (tick yes or no)

No Yes

If yes, you are required to provide a copy of a Safeguarding

5

Policy.24. Will your project involve working with members of the public? (tick yes or no)

No Yes

If yes, you will be required to provide a copy of your Public Liability Insurance.

(If you do not currently have Public Liability Insurance, you can include the cost in your budget to purchase this insurance as

part of your project costs)

Bank Details:25. Does your group have a bank/building society account and do cheques need to be signed by two or more signatories? (tick yes or no)

No Yes

26. If you can answer Yes to questions 20 and 25, complete the box below. If one or both of your answers to 20 or 25 is No, please answer question 27.

Please give us the details of your bank/building society account into which we should pay a grant if you are successful

Name of account: Bank/building society:

Branch:

Account number:

Branch sort code:

27. If you answered No to questions 20 or 25 above, we will want to pay your grant through a formally constituted group if your application is successful. Please tell us below which group will receive a grant on your behalf for this piece of work.Name of the group: Address:

Please give us the details of this group’s bank/building society account into which we should pay a grant if you are successful

Name of account: Bank/building society:

Branch:

Account number:

6

Branch sort code:

28. Please ask the Chair, Treasurer or Chief Executive to sign below to confirm that they are willing to receive the grant on your behalf:

I confirm that my group has agreed to receive a Neighbourhood Partnership Wellbeing Grant on behalf of this group.

Name:

Position:

Group/organisation:

Signed: Date:

Declaration29. Name of person submitting the form:

Signature:

Name: Date:

Position in the group or organisation:

30. For organisations with a Management Committee: Signature of the Chair of the Management Committee (or another member of the Management Committee if the Chair is completing this form). If you are not a formally constituted group, this application must be signed by another member of your group:

Signature:

Name: Date:

7

Checklist, please make sure you have:

Read the guidelines

Answered every question

Enclosed a copy of your constitution, Equal Opportunities Policy and Health and Safety polcy

Enclosed any other relevant information (e.g. safeguarding policies, public liability insurance)

Completed details of your bank account

Signed the form and had it countersigned

If necessary, obtained the details and signature of a constituted organisation to receive your grant on your behalf if you are successful

8