This form is for the financial year 2021 to 2022.
* Which ward are you applying to for grant funding?
Alvaston and Boulton (includes Wilmorton)
Chellaston and Shelton Lock
Sinfin and Osmaston
Contact details * Title
* Your address (including postcode) Contact details of your governing body/management committee.
We may contact members of your governing body if funding is awarded. Chair * Address (including postcode) Treasurer * Address (including postcode) Secretary * Address (including postcode) About your organisation or group * Type of organisation
Registered charity (please give the registration number)
Community or voluntary group
Community interest company (please give the registration number)
Private company or business
* Briefly describe the purpose of your organisation About your project * Describe your project – explain what you want to do overall, who will deliver it and where it will be delivered * How do you know there is a need for your project or activity? Include details of any research or consultation you have carried out. Safeguarding: if your project involves work with vulnerable children, young people or adults please answer the safeguarding question * Does your organisation have appropriate safeguarding in place to protect children, young people and vulnerable adults, including safeguarding policies and procedures, safeguarding training and Disclosure and Barring Service (DBS) checks?
* Please explain why and what procedures you follow to keep children and young people and/or vulnerable adults safe when using your services Equalities * Please tell us how you will ensure that everyone has an equal opportunity to benefit from your project activity Project costs * List all individual project activities * List individual costs for each of the activities you have listed * List amount of budget requested for each of the activities you have listed * List all funds from other sources, and what the source is, for each of the activities you have listed * Is any funding from other sources already available/in place?
* Please provide details of where funds from other sources is already in place and the amounts. This should match the total amount previously specified in funds from other sources Project beneficiaries * Do you plan to continue with your project once any funding has ended? If so,
tell us how you plan to do this. If it is a one-off project, explain how the benefits will be sustained for the participants.
Bank details. The bank or building society account must be in the name of your organisation and must have at least two people to sign each cheque or withdrawal. These two people must not be related. * Organisation or group address (including postcode) Confirmation