Bright Spots Competition Application Form

Bright Spots Competition Entry Form

Win a garden for your community worth up to £1000. Does your local area suffer from fly-tipping or littering issues? Do you know of an outdoor community space that could be brightened up? Areas that are visually appealing not only increase the quality of our local environment but send out the message that anti-social behaviours such as fly-tipping are not tolerated. We have up to £1000 available to support the transformation of an outdoor community space in need of a bit of love into somewhere attractive and wildlife friendly. Please use this form to tell us what you would like to do and how much you expect it to cost. Work will need to be complete by the 24th December 2021. The money available can only be used for funding goods and materials, up to the value of £1000, which we will purchase on your behalf. For example, you may decide that you need planters, peat-free compost and some wildlife friendly flowers. You should submit your application on or before 16th May 2021. A panel made up of the Living Levels Team and Fly-tipping Action Wales will judge the submissions and help make the winning entry a reality.
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Applicant Contact Details

Please add all relevant contact information below. Completion of this section is required to continue the application process.
Do you want to apply for the Bright Spots Competition?

YesNo
Applicant Name

First NameLast Name
Applicant Address

Street Address

Street Address Line 2

CityCounty

Postcode
Applicant Phone Number
Add your contact phone number here. If no mobile number is available please type NA.
Applicant Mobile Phone Number
Add your contact mobile phone number here. If no mobile number is available please type NA.
Applicant Email
example@example.com
Group Affiliation Contact Details

Please add all relevant contact information below. Completion of this section is required to continue the application process.
Do you belong to any of the following?

Community GroupCommunity CouncilOrganisationLocal Resident GroupNoneOther
Thank you for your interest in applying to our Bright Spots Competition.

Unfortunately, qualifying applicants are required to belong to and be applying on behalf of an established community group or organisation.

Further information on fly-tipping including Duty of Care for homeowners and businesses can be found at www.flytippingactionwales.org.
If applying as a member of a group or organisation, please provide the full details of the group including;
Group Name
Please add name or type of other group such as a Religious Institution, Local Interest Group etc.
Group Type
Please type of other group such as a Religious Institution, Local Interest Group etc.
Group Address

Street Address

Street Address Line 2

CityCounty

Postcode
Group Email
example@example.com
Group Phone Number
Add your contact phone number here. If no mobile number is available please type NA.
Are you a registered group with a treasury and bank account?

YesNoDon't Know
Does your group hold Public Liability Insurance? (This is not essential in order to apply)

YesNoDon't Know
Your Application Details

Please add all relevant contact information below. Completion of this section is required to continue the application process.
Where is the location of your proposed community pollinator garden?
Please provide the details of this location with as much information as possible. Include address, latitude, longitude, what3words, Google Maps link etc
If available, please upload an image(s) or videos of the proposed location.

Ensure your safety is your top priority if attempting to take any photos or videos of the proposed location.
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Is fly-tipping a problem at this location?

YesNoDon't Know
Please indicate on the scale below how much of a problem fly-tipping is within your community.

1

2

3

4

5

6

7

8

9

10

1 is No problem, 10 is Major problem
Is littering a problem at this location?

YesNoDon't Know
Please indicate on the scale below how much of a problem littering is within your community.

1

2

3

4

5

6

7

8

9

10

1 is No problem, 10 is Major problem
Has there been any reporting to the local authority of fly-tipping at this location?

YesNoDon't Know
If available, please provide any further information regarding these reports or actions undertaken by the local authority regarding the reported fly-tipped waste.
Add any possible details that would support your application here. Please consider adding dates, times, waste type etc.
Do you have land access rights for this location?

YesNoDon't Know
Please explain the access you have to this land.
Please provide any and all details you have regarding land access including public access to the proposed location of your submission.
Please upload any documents or evidence of the Land Access you have if available.

Written permission from land owner, deeds, Land Registry details etc.
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Please describe your proposal.
Please include how you will 1. work with your community, 2. explain the items your proposed garden will consist of and 3. how you will maintain your garden.
How much will your proposal cost?
Please provide costing information here.
Should be Empty: