Neighbourhood Board Devolved Budget Funding Application

Please read the application form guidance before completing the form.

We will treat all information provided in confidence and in accordance with our privacy notice.

The fields marked with an asterisk (*) are required fields. All the information you enter will be submitted securely.

* Which ward are you applying to for grant funding?

Please select Abbey Allestree Alvaston North Alvaston South Arboretum Blagreaves Chaddesden East Chaddesden North Chaddesden West Chellaston and Shelton Lock Darley Littleover Mackworth and New Zealand Mickleover Normanton Oakwood Sinfin and Osmaston Spondon

* Name of your organisation or group

Contact details

* Title

Please select Mr Mrs Miss Ms Mx Dr Rev Other

* First name

* Last name

* Position in your organisation

* Your address (including postcode)

* Email address

* Confirm Email address

Email addresses do not match.

* Telephone (including area code)

Contact details of your governing body/management committee. We may contact members of your governing body if funding is awarded.

Chair

* Name

* Telephone (including area code)

* Email address

* Confirm Email address

Email addresses do not match.

* Address (including postcode)

Treasurer

* Name

* Telephone (including area code)

* Email address

* Confirm Email address

Email addresses do not match.

* Address (including postcode)

Secretary

* Name

* Telephone (including area code)

* Email address

* Confirm Email address

Email addresses do not match.

* Address (including postcode)

About your organisation or group

* Type of organisation

Please select Registered charity (please give the registration number) Community or voluntary group Community interest company (please give the registration number) Private company or business School Other

* Registration number

* Other organisation (for example: Council department or statutory partner)

* 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.

* What is the estimated completion date of your project?

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 select No Yes

* 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 select No Yes

* 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

* How many people will benefit from your project?

* How many people that will benefit, live within the board ward boundary?

* What is their age group?

* 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)

* Bank or building society name

* Branch address

Sort code

Bank account number - if applicable

Building society roll number - if applicable

Confirmation

* I confirm that all details submitted are correct and that I have read and agree to the terms and conditions

Yes