Active Cork Communities Resilience Fund Report Form 2021

1
Name of Group:* This field is required.Name of facility, community group or disability service:
2
Name of lead contact person:* This field is required.
First Name
Last Name
3
Lead contact person email:* This field is required.Please enter your email address
example@example.com
4
Confirm lead contact person email address:* This field is required.Please enter your email address
example@example.com
5
Lead contact person phone number:* This field is required.Please enter your mobile contact number
Area Code
Phone Number
6
Fund Allocation Awarded* This field is required.Please enter the funding amount awarded as outlined in your letter of offer
Euro
7
Please confirm the funding allocation has been spent:* This field is required.
Yes, all funding allocated has been spent
No, partial funding allocated has been spent
No, funding allocated has not been spent
8
Please outline the amount of funding that remains unspent and when you expect the funds to be spent.Please Note: It is in the best interest of your organisation to expend the funding as per agreement and in line with the terms and conditions. All funds must be spent by end of November 2021.
Huge
Large
Normal
Small
Ok
Ok
9
If all funds remain unspent, please outline the amount of funding allocated and when you expect the funds to be spent.Please Note: It is in the best interest of your organisation to expend the funding as per agreement and in line with the terms and conditions. All funds must be spent by end of November 2021.
Huge
Large
Normal
Small
Ok
Ok
10
Please tick the areas in which you expended funds:
Training & Education
Participation Opportunities In Sport & Physical Activity
Equipment & Resource Provision
Communication & Marketing
11
Invoices UploadThis is a funding requirement, please upload copies of the invoices or receipts for proof of expenditure here. A selection of projects will be subject to spot checks/site visits as outlined in the terms and conditions.
Drag and drop files here
Select files to upload
Max. file size: 19.5MB
Cancelof
12
Please list actions / items purchased in each area:* This field is required.Provide a description of all items purchased in each area similar to the examples below (proof of expenditure required) Communication & Marketing i.e. Promotional Video €875. Equipment & Resource Provision i.e. Play bag and Equipment €250. Training and Education i.e. Delivered 2 participants attended Sports First Aid Courses | 1 x Safeguarding Workshop i.e. €80 Participation Opportunities i.e. 8-week Physical Activity Classes | Older Adults Programme | Family Fun Day i.e. €240 If you did not expend the fund in a particular area please put in N/A (Not Applicable) in the relevant section and 0 in the Funding Expended Total Cost section.
1. Training & Education - items purchased included
Funding Expended Total Cost
2. Participation Opportunities - items purchased included
Funding Expended Total Cost
3. Equipment and Resource Provision - items purchased included
Funding Expended Total Cost
4. Communication and Marketing - items purchased included
Funding Expended Total Cost
13
Please provide details of any training and education opportunities your staff/volunteers attended or you delivered as a result of the funding received, where applicable.Sample Title of training and education: Sports First Aid Provider: Sport Ireland / Cork Sports Partnership Duration of workshop:- 3 hr workshop Number of participants - 8 Number of participants with a disability - 2 Total number of females - 4 Total number of males - 4
Title
Provider
Duration of workshop
No of Participants
No of participants with a disability
No of Female Participants
No of Male Participants
Sport or Physical Activity
Workshop 1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
Row 0, Column 6
Row 0, Column 7
Workshop 2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Row 1, Column 5
Row 1, Column 6
Row 1, Column 7
Workshop 3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Row 2, Column 5
Row 2, Column 6
Row 2, Column 7
Workshop 4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
Row 3, Column 5
Row 3, Column 6
Row 3, Column 7
Workshop 5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Row 4, Column 4
Row 4, Column 5
Row 4, Column 6
Row 4, Column 7
Workshop 1
Workshop 2
Workshop 3
Workshop 4
Workshop 5
Title
Row 0, Column 0
Provider
Row 0, Column 1
Duration of workshop
Row 0, Column 2
No of Participants
Row 0, Column 3
No of participants with a disability
Row 0, Column 4
No of Female Participants
Row 0, Column 5
No of Male Participants
Row 0, Column 6
Sport or Physical Activity
Row 0, Column 7
Title
Row 1, Column 0
Provider
Row 1, Column 1
Duration of workshop
Row 1, Column 2
No of Participants
Row 1, Column 3
No of participants with a disability
Row 1, Column 4
No of Female Participants
Row 1, Column 5
No of Male Participants
Row 1, Column 6
Sport or Physical Activity
Row 1, Column 7
Title
Row 2, Column 0
Provider
Row 2, Column 1
Duration of workshop
Row 2, Column 2
No of Participants
Row 2, Column 3
No of participants with a disability
Row 2, Column 4
No of Female Participants
Row 2, Column 5
No of Male Participants
Row 2, Column 6
Sport or Physical Activity
Row 2, Column 7
Title
Row 3, Column 0
Provider
Row 3, Column 1
Duration of workshop
Row 3, Column 2
No of Participants
Row 3, Column 3
No of participants with a disability
Row 3, Column 4
No of Female Participants
Row 3, Column 5
No of Male Participants
Row 3, Column 6
Sport or Physical Activity
Row 3, Column 7
Title
Row 4, Column 0
Provider
Row 4, Column 1
Duration of workshop
Row 4, Column 2
No of Participants
Row 4, Column 3
No of participants with a disability
Row 4, Column 4
No of Female Participants
Row 4, Column 5
No of Male Participants
Row 4, Column 6
Sport or Physical Activity
Row 4, Column 7
1 of 5
14
Please provide details of any physical activity programmes/events delivered as a result of the funding received, where applicable.Sample Title of programme/event: Couch 2 5K Provider: Community volunteers Duration: 6-weeks Number of participants - 15 Number of participants with a disability - 4 Total number of females - 8 Total number of males - 7
Title / Activity
Provider
Duration of Programme
No of Participants
No of participants with a disability
No of Female Participants
No of Male Participants
Programme/Event 1
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Row 0, Column 5
Row 0, Column 6
Programme/Event 2
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Row 1, Column 5
Row 1, Column 6
Programme/Event 3
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Row 2, Column 3
Row 2, Column 4
Row 2, Column 5
Row 2, Column 6
Programme/Event 4
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Row 3, Column 3
Row 3, Column 4
Row 3, Column 5
Row 3, Column 6
Programme/Event 5
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Row 4, Column 3
Row 4, Column 4
Row 4, Column 5
Row 4, Column 6
Programme/Event 6
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Row 5, Column 3
Row 5, Column 4
Row 5, Column 5
Row 5, Column 6
Programme/Event 7
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Row 6, Column 3
Row 6, Column 4
Row 6, Column 5
Row 6, Column 6
Programme/Event 8
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Row 7, Column 3
Row 7, Column 4
Row 7, Column 5
Row 7, Column 6
Programme/Event 9
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Row 8, Column 3
Row 8, Column 4
Row 8, Column 5
Row 8, Column 6
Programme/Event 10
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Row 9, Column 3
Row 9, Column 4
Row 9, Column 5
Row 9, Column 6
Programme/Event 1
Programme/Event 2
Programme/Event 3
Programme/Event 4
Programme/Event 5
Programme/Event 6
Programme/Event 7
Programme/Event 8
Programme/Event 9
Programme/Event 10
Title / Activity
Row 0, Column 0
Provider
Row 0, Column 1
Duration of Programme
Row 0, Column 2
No of Participants
Row 0, Column 3
No of participants with a disability
Row 0, Column 4
No of Female Participants
Row 0, Column 5
No of Male Participants
Row 0, Column 6
Title / Activity
Row 1, Column 0
Provider
Row 1, Column 1
Duration of Programme
Row 1, Column 2
No of Participants
Row 1, Column 3
No of participants with a disability
Row 1, Column 4
No of Female Participants
Row 1, Column 5
No of Male Participants
Row 1, Column 6
Title / Activity
Row 2, Column 0
Provider
Row 2, Column 1
Duration of Programme
Row 2, Column 2
No of Participants
Row 2, Column 3
No of participants with a disability
Row 2, Column 4
No of Female Participants
Row 2, Column 5
No of Male Participants
Row 2, Column 6
Title / Activity
Row 3, Column 0
Provider
Row 3, Column 1
Duration of Programme
Row 3, Column 2
No of Participants
Row 3, Column 3
No of participants with a disability
Row 3, Column 4
No of Female Participants
Row 3, Column 5
No of Male Participants
Row 3, Column 6
Title / Activity
Row 4, Column 0
Provider
Row 4, Column 1
Duration of Programme
Row 4, Column 2
No of Participants
Row 4, Column 3
No of participants with a disability
Row 4, Column 4
No of Female Participants
Row 4, Column 5
No of Male Participants
Row 4, Column 6
Title / Activity
Row 5, Column 0
Provider
Row 5, Column 1
Duration of Programme
Row 5, Column 2
No of Participants
Row 5, Column 3
No of participants with a disability
Row 5, Column 4
No of Female Participants
Row 5, Column 5
No of Male Participants
Row 5, Column 6
Title / Activity
Row 6, Column 0
Provider
Row 6, Column 1
Duration of Programme
Row 6, Column 2
No of Participants
Row 6, Column 3
No of participants with a disability
Row 6, Column 4
No of Female Participants
Row 6, Column 5
No of Male Participants
Row 6, Column 6
Title / Activity
Row 7, Column 0
Provider
Row 7, Column 1
Duration of Programme
Row 7, Column 2
No of Participants
Row 7, Column 3
No of participants with a disability
Row 7, Column 4
No of Female Participants
Row 7, Column 5
No of Male Participants
Row 7, Column 6
Title / Activity
Row 8, Column 0
Provider
Row 8, Column 1
Duration of Programme
Row 8, Column 2
No of Participants
Row 8, Column 3
No of participants with a disability
Row 8, Column 4
No of Female Participants
Row 8, Column 5
No of Male Participants
Row 8, Column 6
Title / Activity
Row 9, Column 0
Provider
Row 9, Column 1
Duration of Programme
Row 9, Column 2
No of Participants
Row 9, Column 3
No of participants with a disability
Row 9, Column 4
No of Female Participants
Row 9, Column 5
No of Male Participants
Row 9, Column 6
1 of 10
15
Please online the actions implemented in relation to the following areas: Equipment and Resource Provision, Communication and Marketing.Sample funding spent outline: - Equipment - Play Bag and Equipment purchased to support the delivery of a Family Fun Day - Communication & Marketing - Promotional Video created to increase awareness of our group
Huge
Large
Normal
Small
Ok
Ok
16
Please outline briefly the key outcomes and successes as a result of receiving this funding:IPlease outline briefly the key outcomes and successes as a result of receiving this funding:
Huge
Large
Normal
Small
Ok
Ok
17
Photos UploadPlease attach photos of programmes, initiative or events in action here and any photos of equipment purchased.
Drag and drop files here
Select files to upload
Max. file size: 19.5MB
Cancelof
18
Date* This field is required.Today's Date
Date
Day
Month
Year
19
Signature* This field is required.Please sign the here on behalf of your group to confirm all details provided are accurate and in line with the Active Cork Community Resilience Fund Terms and Conditions.
Should be Empty: